Your Body-Composition Report Goes Below

Name:   Age:   Date: 

Gender M/F:   Weight:   Height: 

Skin-Fold Measurements in Millimeters
Triceps:
Suprailiac (Hip):
Umbilicus (Stomach):
Thigh:
Sum (Triceps + suprailiac + umbilicus + thigh) =

Formula for men:
Percent Bodyfat = 0.29288(sum of four skin folds) - 0.0005(sum of four skin folds)2 + 0.15845(age)-5.76377 

Formula for women:
Percent Bodyfat = 0.29669(sum of four skin folds) - 0.00043(sum of four skin folds)2 + 0.02963(age)+1.4072 
Bodyfat % = 
Fat Weight (Bodyfat % x Scale Weight) = 
Lean Body Mass (Scale Weight - Fat Weight) = 
Formulas created by Experimental and Applied Science, Inc.

Measurements done by Advance PT and Sport Rehabilitation. P.C. Authenticated by attachment of receipt from APT&SR.