SISSFFIT015 Portfolio Assessment for Desklib

The SISSFFIT015 Portfolio Assessment is a fitness program that requires a referral from a medical or allied health professional. The assessment includes a case study of a 51-year-old male client who has been referred from a doctor. The assessment criteria include referring to medical or allied health professionals, receiving and responding to referrals, and delivering and monitoring client fitness programs. The assessment also includes a true/false section on risk factors.

Assessment 1- Portfolio (SISSFFIT015)
Student Name: Marianna Sofianidou Student ID: CSF 160063
Assessment Type: Portfolio Other: Portfolio
Assessor’s Name:
Assessment
Outcome:
☐ Satisfactory ☐ Not Yet Satisfactory
Student
Declaration:
By submitting this assessment via Moodle, I declare that this is my own work and had
not been copied or plagiarised from any other source. Please refer to the Student
Handbook for more information.
Assessment
Conditions:
Each assessment criteria is recorded as either Satisfactory (S) or Not Yet Satisfactory
(NYS). A student can only achieve a ‘Satisfactory’ Assessment Outcome for the entire
assessment when all assessment Criteria listed below are ‘Satisfactory’. A student who
is assessed as ‘Not Yet Satisfactory’ is eligible for re-assessment with their trainer.
All assessment answers must be typed, include this assessment cover sheet and
uploaded in ‘WORD’ version to moodle.
Assessment Criteria
Element Performance Criteria S NYS
1. Refer to medical or
allied health
professional.
1.1 Analyse client pre-exercise screening, risk stratification, and
relevant fitness testing results.
☐ ☐
1.2 Collect relevant health information from client as required. ☐ ☐
1.3 Identify need for referral and guidance from medical practitioner
or appropriate allied health professional.
☐ ☐
1.4 Determine appropriate medical or allied health professional for
client referral.
☐ ☐
1.5 Obtain informed consent from client for the purpose of sharing
client information with health professionals, including referrals.
☐ ☐
1.6 Conduct referral in accordance with industry endorsed referral
procedures.
☐ ☐
2. Receive and
respond to referrals. 2.1 Receive guidance from medical or allied health professional. ☐ ☐
2.2 Seek verbal or written clarification from medical or allied health
professional, if required.
☐ ☐
2.3 Clarify recommendations with client and answer queries as
required.
☐ ☐
3. Deliver and monitor
client fitness program 3.1 Deliver exercise in accordance with guidance received from
medical or allied health professional, within industry endorsed scope
☐ ☐
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
of practice.
3.2 Monitor client responses to exercise and make appropriate
adjustments as required.
☐ ☐
3.3 Respond to signs and symptoms of exercise intolerance and take
appropriate action within scope of practice.
☐ ☐
3.4 Refer client to appropriate medical practitioner or allied health
professional if required.
☐ ☐
4. Report on client
progress. 4.1 Maintain records of client participation and progress. ☐ ☐
4.2 Provide feedback to relevant medical or allied health professional
in a timely manner using industry endorsed referral reporting
procedures.
☐ ☐
4.3 Receive further guidance from medical or allied health
professional and modify exercise program and delivery as required.
☐ ☐
4.4 Provide feedback to client on progress and any recommended
adjustments to exercise program.
☐ ☐
5. Maintain client
records. 5.1 Identify and record information for communication and reporting
to relevant medical or allied health professionals.
☐ ☐
5.2 Update and maintain current client. ☐ ☐
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Part A
Case study – Provide referral (15 marks)
Task:
1. Provide a profile of a medical and/or allied health professional who could be chosen to
communicate with about the case study client outlined below. You will need to communicate
with a medical and/or allied health professional in regards to clearance before prescribing an
exercise program. This will depend on the type/s of medical and allied health professionals
chosen – that is, if the person is only suited to treating patients of a medical nature, an additional
letter and report to an allied health professional may be necessary. Outline their area of expertise
to justify your referral to this medical and/allied health professional. Provide evidence of your
communication with this medical and/or allied health professional.
2. Using the above information, prepare a letter to a relevant medical and/or allied health
professional in regards to the client’s results on his pre-exercise screening form. The letter is to
contain an introduction and an overview of your requirements – that is, you will require
clearance and guidance in order to deliver a fitness program for the client.
3. Prepare a report to support this letter that outlines:
● the results of the pre-exercise screening form and fitness test
● request for clearance to perform these exercises and activities, and/or clearance to perform
alternatives as suggested by the medical and/or allied health professional
● the client’s fitness goals and your view on his goals
● an outline of the client’s risk factors and why these risk factors are beyond your area of
expertise.
Case study – Peter
Peter is a 51-year-old male client at the gym. He has been referred from a doctor. He was recently
involved in a motor vehicle accident (three months ago). Peter suffered from a fractured tibia in the
car accident, which was operated on, and then placed in a plaster of Paris cast for six weeks. He has
recovered well from this operation. The bone is in good condition and cleared for exercise following
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
some early rounds of physiotherapy. Peter’s doctor has recommended that he start going to the gym
to get fit and healthy again. Prior to his motor vehicle accident Peter walked daily, but he has never
exercised in a gym before. Peter reports feeling very tight in the calf muscles and ankle since the
plaster was removed six weeks ago. Peter’s other health information, as provided by his doctor,
includes:
● a blood pressure reading of 142/92 bpm
● asthma (he takes ventolin)
● poor eating habits, such as frequent takeaway lunches at work and dinner, skipping breakfast.
Note: Although this doctor has suggested that Peter join a gym, you should still assume that you will
require clearance from the relevant medical and/or allied health professionals prior to exercise
testing and/or programming when considering Peter’s medical and health status.
Referral letter from Fitness Trainer TO Health Professional
Practitioner Name: Dr Michael Drivas
Clinic: Bankstown Specialist in Broken Bones
Address : 71 Meredith street
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Suburb State Postcode Bankstown NSW 2200
Referral Date: 1/8/17
http://www.physioroom.com/injuries/calf_and_shin/tibia_fibula_fracture_full.php
Dear Practitioner Name, Michael Drivas
Re: Client Name: Peter X
Client Address: 12 Wenworth Ave, Sydney
Client DOB: 27/6/1966
My client Peter X has presented to our Gym facility Fitness First with the goal of improve his overall health status. He
recently involved in motor vehicle accident. But now after three months he take off his Plastic Cast.
Peter information and measurements recorded during pre-exercise screening include the following:
Current
Physical
Activity level
Medium
Sessions / week Notes:
─ Fractured tibia
─ High blood pressure 142/92 mmHg
─ Poor and irregular eating habit
─ Asthma
Minutes / week
Intensity
(low/mod/high/ vig)
Resting HR
Resting BP
Weight 80
BMI 27
Waist Circ
In response to his screening results I am requesting your guidance in relation to Peter’s condition to enable me to ensure
delivery of a safe and effective exercise program.
Based on Peter’s goals, I intend to have him commence an exercise program consisting of the following:
Regular Climbing stairs- Cardio based respiratory improvement program
Regular Bicycling- Cardio based blood pressure reducing program
Aerobics in alternative days- Fat burning exercise that reduces the blood pressure as well
Jogging – Cardio and locomotion based program to improve muscles and bone functionalities and
Please assess Peter’s condition and indicate any recommendations you may have in relation to his exercise program,
including specific activities he cannot or should not be undertaking at this time, or other relevant notes.
I will keep you informed of Peter’s progress and any major changes in his condition. To acknowledge you have received
this referral, please complete this section:
Date Referral received: 12/5/18 Status of Referral:
*please describe action required in notes Complete Incomplete*
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Practitioner Name: MICHAEL Contact person for follow up:
**please provide new contact details in notes As above New
contact**
Practitioner Title: DRIVAS Notes:
Practitioner Signature: MICHAEL DRIVAS
Please include in notes any instructions you may have regarding follow up or progress reporting.
I welcome any advice you feel necessary and can be contacted by phone <123456789> during <9AM-5PM > or email <
[e-mail]> anytime.
Client Consent: I give my permission for Professional/Business to communicate with the referring Practitioner
and/or my GP regarding my health status and my progress relating to my exercise program.
Client Name: Peter x
Client Signature: Peter x Date: 12/5/18
Your Sincerely,
Marianna Sofianidou
Contact Name
Business Name fitness for well-being
Phone: Your Phone Number
Email: [e-mail]
Postal Address 71 Meredith street
Suburb Bankstown State NSW Postcode 2200
Business/Facility Opening Hours 9am-5pm
3. Report to support the letter:
According to the Screening report and fleetness test Pater has very poor eating habits. He often skips
his breakfast or dinner. He also frequently takes launch and dinner within a short period. The
irregular eating habit has made his digestion system weak and deficient. Peter has 27 BMI which is
not very high. However he has high blood pressure that frequently hinders his daily activities. He
has chronic Bronco Infection that leads to Asthma. Currently he is taking ventolin for medication.
The above latter is made to request for clearance from a general medical practitioner named
Michael Drivas. This letter is intended to receive any suggestion from the practitioner about the
regular physical activities of Peter. The goal of the fitness program is to improve the fitness of the
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Peter. The high blood pressure of Peter needs immediate weight losing and cardiac exercise. At the
same time the fitness procedure should be concerned about the asthma problem of the client.
Peter recently has recovered from the tibia fracture which needs additional care and protection. The
tibia is a valuable bone that helps him do any movement activity. Apart from that if the current
condition needs any special activities or program, the identification of the requirement would be out
of my expertise. Any misguidance in this vulnerable condition of Peter can lead to risky condition or
severe injury.
Part B
True/False – Risk factors (25 marks)
Select the correct answer.
True False
1. A referral from a fitness trainer to a general
practitioner should note a current medical
history of hospitalisation and infectious
disease.
✓ True False
2. Mononucleosis is not an infectious disease
and clients are recommended to train during
the illness.
True ✓ False
3. Pregnancy is always a cause for referral for
clearance from a medical professional to
conduct a fitness test and/or fitness program.
✓ True False
4. A family history of a heart attack or stroke is
one risk factor that contributes to the need
for referral to a medical practitioner.
✓ True False
5. Low-risk clients are men under 45 and
women under 55, who are asymptomatic and
have no more than one coronary risk factor.
True ✓ False
6. Moderate-risk clients have a known
cardiovascular, pulmonary or metabolic
True ✓ False
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
disease and three coronary risk factors.
7. High-risk clients will most likely require
exercise guidance from a doctor and/or an
accredited exercise physiologist.
✓ True False
8. A recent myocardial infarction is an absolute
contraindication to exercise testing. ✓ True False
9. Unstable angina is an absolute
contraindication to exercise testing. ✓ True False
10. Acute myocarditis is inflammation of the
cardiac muscle. ✓ True False
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
11. Severe hypertension is always an absolute contraindication to
exercise. ✓ True False
12. Chronic infectious diseases, such as hepatitis, are relative
contraindications to exercise and exercise testing. ✓ True False
13. Neuromuscular conditions exacerbated by exercise are relative
contraindications to exercise. ✓ True False
14. Fitness trainers should refer current musculoskeletal injuries to
an appropriate allied health professional, such as a
physiotherapist.
✓ True False
15. Diastolic blood pressure greater than 110mm/Hg at rest
warrants medical referral. ✓ True False
16. A Type 2 diabetic client will never require insulin as part of
their treatment. True ✓ False
17. The quadriceps muscles are made up of the rectus femoris,
vastuslateralis and vastusmedialis only. True ✓ False
18. Patellofemoral pain syndrome is a common dysfunction seen in
clients with anterior knee pain. ✓ True False
19. The Achilles tendon is responsible for connection of the
gastrocnemius to the calcaneus. ✓ True False
20. The Tibialis anterior is responsible for plantarflexion of the
ankle. ✓ True False
21. The equivalent bones in the foot and hand are tarsals and
carpals respectively. ✓ True False
22. High blood glucose levels are greater than about 1mmol/L. ✓ True False
23. High blood glucose levels (greater than 15mmol/L that last
longer than 24 hours may start to result in the signs of
hyperglycaemia.
✓ True False
24. Hyperglycaemia will not result in thirst. True ✓ False
25. HDL cholesterol is known as the ‘bad cholesterol’. True ✓ False
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Part C
Case study – Referral (15 marks)
This task involves the receiving of simulated referrals from medical and allied health professionals
and making decisions as to what plan of action you might take in response to each referral. Each
referral situation is provided as a case study.
Katherine X
Dr Jones is a local general practitioner. He has referred Katherine to you (as a fitness trainer)
because he would like her to start exercising. Katherine is obese, reporting poor dietary habits, and
has Type 2 diabetes. Her resting blood pressure is 145/91mmHg. Katherine has arrived at the gym to
buy a membership based on Dr Jones ‘telling me to come and see you’. The referral letter is as
follows:
Dear Sir/Madam,
Katherine X is a 57-year-old female patient who has recently been diagnosed with Type 2 diabetes.
Katherine is still learning about this condition and would benefit from further education and lifestyle
modification. Her blood pressure is 145/91mmHg and she has commenced medication to assist in
this being reduced. She will need an exercise program to assist with management of her condition.
She is 89kg and 168cm tall.
Regards,
Dr Jones.
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Task:
1. Complete a pre-activity questionnaire form for Katherine, filling in the information that you
expect she would be able to fill in based on the information provided by Dr Jones. (Note: Even
though it would be Katherine who would normally complete this form, this task will help you to
demonstrate the ability to record health information for Katherine based on Dr Jones' referral.)
PARQ
NAME Katherine
AGE 57 years old
PHONE [phone]
ADRESS 22 MEREDITH STREET BANKSTOWN
EMERGENCY CONTACT DETAIL SON, JAMES SMITH 04444666777
1/ Do you have, or have you had:
 heart disease (please specify):
 high blood pressure
  high cholesterol
 diabetes
 lung disorder (eg. asthma,
emphysema) other cardiac
problem (incl. pacemaker,):
 no/ or none of the above.
2/ Have you ever been told you are at
risk of:
6/ Have you ever had pain or pressure,
either at rest or during exercise:
 in the middle of, or on the left side
of, the chest,
 in the neck region,
 at the left shoulder or down the
left arm.
 no/ or none of the above.
7/ Do you take any medications for
(please name):
 heart disease:
……………………………
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
 heart disease
  high blood pressure
 high cholesterol 
 diabetes  stroke
 no/ or none of the above.
3/ Have you ever been told that you
have heart problems, eg.:
 heart murmur  valve defect
 racing heart  irregular beats
 angina
 other:
 no/ or none of the above.
4/ Do you have, or have you
experienced:
 epilepsy  fainting  seizures
 dizzy spells  convulsions
 no/ or none of the above.
5/ Do you experience sudden
shortness of breath?
YES NO
 Diabetes cholesterol:
…………………………
 blood pressure:…
145/91mmHg………………………...
 asthma, breathing problems:
…………..
 no/ or none of the above.
8/ Are you aged over 60 years of age:
 Yes  No
9/ Do you have any joint or muscular
problems that may affect your ability to
train:
 Yes  No
If yes, please explain:
10/ Do you have any other conditions
or injuries that may affect your ability
to train:
 Yes  No
If yes, please explain:…………
strongly recommends that you consult your doctor and obtain medical clearance prior to commencing any exercise program, as
a certain level of risk is inherit in any exercise program. Any information, instruction or advice obtained from Active8 staff may
not be substituted for your doctor’s advice or treatment, and that any instruction or advice is obtained t your own risk. You
agree to release and discharge Active8 & Richmond Club, it’s staff and directors from any and all responsibilities or liabilities
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
from injury or illness arising from your participation in any activity undertake at Active8 or upon our advice.
Administration Only - Referral to Medical Practitioner required?
 Client is: aged 18-60 and has no risk factors >>> cleared for moderate exercise
prescription
 Client responded to one or more of Cardio-Respiratory risks >>> refer to Doctor for clearance
Signatures: Client:KATHERINE Staff : ..MARIANNA SOFIANIDOU..... Date: …16/5/18.
2. Write a short report (approximately 500–750 words) outlining:
a) Katherine’s risk factors, including calculation of her BMI for poor health
Obese,
poor eating habits,
Type 2 Diabetes,
High blood pressure 145/91mmHg
b) The relevance of BMI in this situation
She is 89kg and 168cm tall. In this situation she needs to have lower weight. Therefore, it is clear
that this BMI condition also influences her blood pressure. In order to keep his blood pressure
and body weight balanced, she needs to reduce her BMI below 28.5 instead of having BMI
31.5
c) a suggested management plan for Katherine
Katherine is obese patient that must as soon as possible lose weight for her healthier future. The
benefits she will get is not only to how she gonna feel but she will reduce all this risk factors
she already has,such as Type 2 Diabetes. Also by reducing weight she will reduce her future
problem with bones and joints and reduce risk of future cancer.She must reduce the amount
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
of intakes she gets daily and exercising almost 4 days a week. Her BMI must range between
20-25 as per high and must be loose about 17 kg to reach approxematly 70 kg recommend for
her high
d) what guidance you will require from medical and/or allied health professionals prior to
fitness testing and/or fitness programming for Katherine.
 Client’s risk and needs:
Katherine has several risk factors including Obese, poor eating habits, Type 2 diabetes and high
blood pressure. The high BMI report represents her tendency of Obesity. Irregular eating habits
with unhealthy food proportion have lead to this situation with Type 2 diabetes. This high
weight is causing high blood pressure as well. If needed this high blood pressure of
145/91mmHg has to be cured with appropriate medication and other treatment.
 Exercise type:
Jogging – Cardio and locomotion based program to improve muscles and bone functionalities and
Freehand exercise- to increase the flexibility of the body wing enhanced insulin acceptance
Regular Bicycling- Cardio based blood pressure reducing program
Regular Climbing stairs- Cardio based respiratory improvement program
Aerobics in alternative days- Fat burning exercise that reduces the blood pressure as well
3. Write referral letters for medical and/or allied health professionals in your local area that you
might suggest that Katherine should see either before or during your time with her. Ensure you
provide a rationale for your referral.
Practitioner Name KATE HOLMES
Clinic INGRID ORTH DIETITIAN AND NUTRITIONIST
Suburb BANKSTOWN State NSW Postcode 2200
Referral Date: 16/5/18
Dear Mr HOLMES
Re: Client Name: KATHERINE
Client Address: BANKSTOWN
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Client DOB: 57 YEARS OLD
MY client KATHERINE X has presented to our business/service/facility with the goal of lose weight as her GP suggest she
must exercise to reduce her health risk factors such as Type 2 Diabetes
KATHERINE information and measurements recorded during pre-exercise screening include the following:
Current
Physical
Activity level
NOT AT ALL
Sessions / week Notes:
─ TYPE 2 DIABETES
─ BMI -OBESITY
─ HIGH BLOOD PRESSURE 145/91mmHg
─ UNDER MEDICATION
─
Minutes / week
Intensity
(low/mod/high/ vig)
Resting HR
Resting BP
Weight
BMI 31.5
Waist Circ
In response to her screening results I am requesting your guidance in relation to Katherine condition to enable me to
ensure delivery of a safe and effective exercise program. KATHERINE NEED A EATING PROGRAM PLAN WICH WILL HELP
HER TO REDUCE HER BODY WEIGHT AND REDUCE RISK FACTORS AS SUCH SHE IS SUFFER OF
Based on Katherine goals, I intend to have /her commence an exercise program consisting of the following:
Jogging – Cardio and locomotion based program to improve muscles and bone functionalities and
Freehand exercise- to increase the flexibility of the body wing enhanced insulin acceptance
Regular Bicycling- Cardio based blood pressure reducing program
Regular Climbing stairs- Cardio based respiratory improvement program
Aerobics in alternative days- Fat burning exercise that reduces the blood pressure as well
Please assess Katherine condition and indicate any recommendations you may have in relation to her exercise program,
including specific activities /she cannot or should not be undertaking at this time, or other relevant notes.
I/ will keep you informed of KATHERERINE’s progress and any major changes in /her condition. To acknowledge you
have received this referral, please complete this section:
Date Referral received: 16/5/18 Status of Referral:
*please describe action required in notes Complete Incomplete*
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Practitioner Name: KATE HOLMES Contact person for follow up:
**please provide new contact details in notes As above New contact**
Practitioner Title: DIETITIAN Notes:
Practitioner Signature: KATE HOLMES
Please include in notes any instructions you may have regarding follow up or progress reporting.
I/we welcome any advice you feel necessary and can be contacted by phone <123456789> during <9AM-5PM > or
email <[e-mail]> anytime.
Client Consent: I give my permission for Professional/Business to communicate with the referring Practitioner
and/or my GP regarding my health status and my progress relating to my exercise program.
Client Name: Katherine x
Client Signature: Katherine x Date:16/5/18
Your Sincerely,
Marianna Sofianidou
Contact Name
Business Name fitness for well-being
Phone: Your Phone Number
Email: [e-mail]
Postal Address 71 Meredith street
Suburb Bankstown State NSW Postcode 2200
Business/Facility Opening Hours 9am-5pm
Part D 300
Portfolio – Make referrals (15 marks)
You are to demonstrate a collection of evidence in a portfolio showing your ability to identify and
refer clients requiring medical or allied health professional expertise. This task is most suited to
students currently working in the fitness industry and who have been working collaboratively with
medical and allied health professionals; however, your trainer may provide you with simulations as
deemed appropriate, especially for those who have not had sufficient access to the required
situations. Follow the instructions carefully to ensure you complete this task to the detailed level
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
required. You will need to provide a variety of evidence, such as supervisor reports, letters, DVD
recordings and so on. This assessment will need to be performed over a period of time to ensure you
have adequate time to provide the evidence of competency required.
Task:
1. Access information from at least three clients with health or medical concerns that require
medical or allied health professional expertise. Use pre-test screening information and seek
additional health information from the clients as required.
2. Analyse health information to determine the need for referral and guidance. Recommend the
client seek advice from medical or health professionals as required and arrange the referral with
permission, consent and within confidentiality and privacy standards.
3. Maintain a case management file with all documents, communication and collaboration with
medical and allied health professionals.
Client 1:
Name : Ashline Markov Medical Details
Address: 21/A MEREDITH STREET
BANKSHIRE
BP: 130/90 mmHg
Weight: 85
BMI: 32
Age: 32 Medical history
Date of appointment: 12 May, 2018  High Blood pressure Obesity Endocrine abnormalities Unhealthy eating practice
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Current issue
Pregnancy
Back neck pain and burning sensation
Uncontrollable Palpitation and accelerated heartbeat
Agitation during the day time
Restlessness as well as sleeplessness while having excessive fatigue
Recommendation Referral Regular Walking Vitamin E based Diet Avoid hard work Have mentally stress-less environment Avoid any weight lift
As per the result of basic screening test It
has been determined that the patent
needs some expert advice and
medication. I am referring the patient to
Dr. Devid Willium (General Physician) for
further treatment process.
Confidentiality and Privacy Standards: All the collected documents and personal details
of the patient will be considered as the subject of chief Confidentiality and Privacy. The
documents will be used only for medical and physiotherapeutic purposes.
Client 2:
Name : Lorain Martin Medical Details
Address: 12 WENWORTH AVE, SYDNEY BP: 110/65mmHg
Weight: 67
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
BMI: 25
Age: 47 Medical history
Date of appointment: 20 May, 2018  Low weight Osteoporosis Chronic Cardiovascular disorder Unhealthy Diet
Current issue
Post menopausal symptoms
Mild Breathlessness after any physical activity
Accelerated heartbeat
Joint pain in pelvic bone, knee and elbow
Excessive Fatigue
Recommendation Referral Calcium Diet Regular jogging Balanced prescribed diet Breathing Exercise
As per the result of basic screening test It
has been determined that the patent
needs some advance medical diagnosis,
physiotherapy and medication. I am
referring the patient to Dr. Jack Martin
(Endocrinologist) for further treatment
process.
Confidentiality and Privacy Standards: All the collected documents and personal details
of the patient will be considered as the subject of chief Confidentiality and Privacy. The
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
documents will be used only for medical and physiotherapeutic purposes.
Client 2:
Name : Devid Marks Medical Details
Address: 33/A, WENWORTH LANE,
BRISBORN
BP: 130/90mmHg
Weight: 79
BMI: 28
Age: 52 Medical history
Date of appointment: 20 May, 2018  Obese Chronic Bronchitis Arthritis
Current issue
Mild Breathlessness after any physical activity
Accelerated heartbeat
Knee pain
Early Fatigue
Needs of Expert Supervision
Recommendation Referral Calcium Diet As per the result of basic screening test It
has been determined that the patent
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015) Regular Cycling Avoid Dust allergies Breathing Exercise
needs clearance from registered doctor
about his current physiological condition. I
am referring the patient to Dr. Devid
Willium (General Physician) to ensure that
the patient is ready to have next level
physical activities in gym.
Confidentiality and Privacy Standards: All the collected documents and personal details
of the patient will be considered as the subject of chief Confidentiality and Privacy. The
documents will be used only for medical and physiotherapeutic purposes.
Part E 200
Portfolio – Case management (20 marks)
You are to demonstrate a collection of evidence in a portfolio showing your ability to be part of an
entire case management file for two different clients. The goal is to be part of a team that is
managing a client for a particular concern, such as recovery after a motor vehicle accident or other
injury, Type 2 diabetes management and so on. This should involve liaising with local medical and/or
allied health professionals. An example of an appropriate case may include, but are not limited to
the following:
● a pregnant client who has been referred to the gym for an exercise program during her
pregnancy
● a postmenopausal client who has been referred to the gym for a weight-bearing cardiovascular
program and a resistance program to minimise the risk of the onset of osteoporosis
● a client you have referred who has presented to the gym with risk factors warranting guidance
and clearance from a doctor. You then continue managing this client under the care and
supervision of a doctor or allied health professional.
Check your case management file is appropriate with your trainer before submission. You will need
to submit all necessary documentation to support your claims of competency.
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Note: One of your cases should include receiving at least one referral, while the other case should
involve you making at least one referral. Some cases may involve more than one medical and/or
allied health professional. If the client is not officially ‘discharged’ from the medical and/or allied
health professional, the case should be managed for at least two months to ensure adequate time to
demonstrate competency in this task.
Task:
1. Identify information that needs to be recorded in the case management file.
Client Name:
Client Address:
Client Contact number:
Pathophysiological history of client:
Specific information about any pain or regular sufferings:
BMI, Blood pressure, Blood sugar, Cardiac condition and other health report:
Any previous or recent injuries:
Cardiac capacity and breath frequency:
2. Identify information that needs to be shared with medical or allied health professionals and
provide as required.
Pathophysiological history of client:
Specific information about any pain or regular sufferings:
BMI, Blood pressure, Blood sugar, Cardiac condition and other health report:
Any previous or recent injuries:
3. Maintain current, complete, accurate and relevant client records for each client contact.
Pathophysiological history of client:
Specific information about any pain or regular sufferings:
BMI, Blood pressure, Blood sugar, Cardiac condition and other health report:
Any previous or recent injuries:
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C

Assessment 1- Portfolio (SISSFFIT015)
Cardiac capacity and breath frequency:
VC001 College of Sports & Fitness - 11/05/2017- SISFFIT015
International College of Capoeira Pty Ltd trading as ’College of Sports & Fitness’ ABN 90 125 114 730/ Registered
Training Organisation 91345/ CRICOS Provider Code 03057C