Name

Email

Date and Time

Name

Sex

• Male

• Female

Height (feet)

Weight (kl)

Does the athlete have any medical conditions or surgeries affecting swimming performance?

Equipment

• Wetsuit

• Snorkel

• Bands

• Paddles

• Goggles

• Kickboard

• Pull Buoy

• Fins

• Hand Paddles

Athlete's Skills

• Freestyle

• Backstroke

• Butterfly

• Breaststroke

• Flip Turn

• Treading Water

• Sidestroke

Pool Type

• Indoor

• Outdoor

• 25 Yards

• 50 Meters

General Coordination

Arm Pull Pattern

Leg Kick Timing

Breathing Pattern

Posture

Shoulder Rotation

Hip Rotation

Stroke Recovery

Kick Rhythm

Head Position

Entry and Exit of Hand

Glide Efficiency

Turn Technique

Finish Technique

Heart Rate (After Assessment)

Stroke Count per Lap

Speed (Time per Lap)

Distance Per Stroke