2019 USDA FS-5100-31-2026

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The document is a Health Screening Questionnaire (HSQ) from the USDA Forest Service designed to assess the health risks of individuals before they participate in the Work Capacity Test (WCT). It includes questions regarding cardiovascular health, physical activity levels, and other medical conditions that may affect performance. The HSQ aims to identify those at risk and recommend appropriate exercise programs or medical evaluations. It emphasizes the importance of truthful responses and outlines privacy protections under federal law.

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Click ‘Get Form’ to open the 2019 USDA FS-5100-31 in our editor.
Begin with Section A, where you will mark all applicable health conditions. Carefully read each statement and select those that apply to your health history.
Next, move to the questions regarding your experiences in the last 12 months. Indicate any symptoms or health issues that may affect your ability to participate in strenuous activities.
Proceed to Section B, focusing on cardiovascular risks. Here, you will assess your physical activity level and body mass index (BMI). Make sure to provide accurate information as it is crucial for your evaluation.
Finally, review the Privacy Statement and ensure you understand the implications of your responses. Sign and date the form before submitting it through our platform.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (142 Votes)
2013	4.7 Satisfied (48 Votes)
2009	4 Satisfied (21 Votes)

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