VO₂ Max Treadmill Testing – Medical Waiver and Informed Consent

Participant Name: _____________________________________
Date of Birth: ____________ Phone Number: __________________

Emergency Contact Name: ___________________________
Phone Number: ___________________________

PURPOSE OF TESTING

The purpose of this test is to measure your maximal oxygen consumption (VO₂ max) using a graded exercise protocol on a treadmill. This information helps assess cardiorespiratory fitness and guide training or health-related decisions.

TEST DESCRIPTION

The VO₂ max test involves exercising on a treadmill with increasing speed and/or incline until volitional fatigue. You will wear a face mask connected to a metabolic analyzer (e.g., VO2 Master) and may wear a heart rate monitor. The test will be supervised by trained personnel.

RISKS AND DISCOMFORTS

As with any exercise, there are risks that include but are not limited to:

  • Elevated heart rate and blood pressure

  • Dizziness or fainting

  • Musculoskeletal injury (e.g., muscle strain)

  • In rare cases, abnormal heart rhythms, heart attack, or death

Every effort will be made to minimize these risks through proper screening, supervision, and emergency procedures.

PARTICIPANT RESPONSIBILITIES

To ensure safety and validity of the test, you agree to:

  • Disclose any relevant medical history or symptoms (chest pain, shortness of breath, etc.)

  • Follow instructions from testing personnel

  • Notify staff immediately if you feel unwell at any point

CONTRAINDICATIONS

You should NOT participate in this test if you have:

  • Known cardiovascular, pulmonary, or metabolic conditions without physician clearance

  • Uncontrolled high blood pressure

  • Acute illness or injury

  • Pregnancy without medical approval

VOLUNTARY PARTICIPATION & RIGHT TO WITHDRAW

Your participation is voluntary. You may refuse or discontinue the test at any time, without penalty.

RELEASE OF LIABILITY

By signing below, I acknowledge and agree to the following:

  • I understand the nature, purpose, and potential risks of the VO₂ max treadmill test.

  • I have had the opportunity to ask questions and all questions were answered to my satisfaction.

  • I assume all risks associated with participation.

  • I release the testing facility, its staff, and affiliates from any liability for injury, illness, or adverse event that may result from this test, unless caused by gross negligence.

Signature of Participant: ____________________________
Date: ________________

Signature of Witness/Staff: __________________________
Date: ________________