Fms Scoring Sheet(Da Stampare)

THE FUNCTIONAL MOVEMENT SCREEN SCORING SHEET

 NAME

DATE DATE

DOB

ADDRESS CITY, STATE, ZIP

PHONE

SCHOOL/AFFILIATION

    S     M SSN     F PRIMARY SPORT

HEIGHT

WEIGHT

AGE

GENDER

 

PRIMARY POSITION

HAND/LEG DOMINANCE

PREVIOUS TEST SCORE RAW RAW

TEST

SCORE

FINAL SCORE

COMMENTS

DEEP SQUAT L HURDLE STEP R  L INLINE LUNGE R  L SHOULDER MOBILITY R  L IMPINGEMENT CLEARING TEST R  L ACTIVE STRAIGHT-LEG RAISE R  TRUNK STABILITY PUSHUP PRESS-UP CLEARING TEST L ROTARY STABILITY R  POSTERIOR ROCKING CLEARING TEST

TOTAL

This s!"# is $s#% &! %#'!&# "i(h& )'% *#+& si%# s!"i'( Th# "i(h& )'% *#+& si%#s )"# s!"#% i' +i# !+  &h# s##' &#s&s )'% .!&h )"# %!$#'&#% i' &his s0)# Final Score: This s!"# is $s#% &! %#'!&# &h# !#")** s!"# +!" &h# &#s& Th# *!1#s& s!"# +!" &h# ")1 s!"# 2#)h si%#3 is )""i#% !#" &! (i# ) +i')* s!"# +!" &h# &#s& A 0#"s!' 1h! s!"#s ) &h"## !' &h# "i(h& )'% ) &1! !' &h# *#+& 1!$*% "##i# ) +i')* s!"# !+ &1! Th# +i')* s!"# is &h#' s$)"i4#% )'% $s#% )s ) &!&)* s!"# Raw Score: