Walking Studies
Daily Walking Journal

Thank you for participating in this Walking Studies International, LLC research program. We appreciate your willingness to volunteer and your candidness in answering medical and fitness related questions. Your answers will be monitored for market research purposes; however, your identity will always remain anonymous and confidential until you give express written permission.

Please complete this form THE SAME DAY on any day that you walk.



Gender (Male or Female):

Date of Birth (Age):

Walking Route (Geography):

Distance:

Total Steps:

Time:

Resting Heart Rate:

Max Heart Rate:


Walking Weight Used:
None
3 Pound
5 Pound
Indicate Your Primary Reason for Walking Today:

Observations (medical issues):

Achievements (fitness performance):





 

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