Work Capacity Test: Informed Consent 	

•	Pack Test- Arduous The 3-mile test with a 45 pound pack in 45 minutes is strenuous, but no more so than the duties of wildland firefighting.  

•	Field Test-Moderate The 2-mile test with a 25 pound pack in 30 minutes is fairly strenuous, but no more so than the field duties.

•	Walk Test-Light The 1-mile walk in 16 minutes is moderately strenuous, but no more so than the duties assig. 	
Risks
  
•	There is a slight risk of injury (blisters, sore legs, sprained ankles) especially for those who have not practiced the test.  If you have been inactive and have not practiced or trained for the test, you should engage in several weeks of specific training before you take the test.  Be certain to warm up and stretch before taking the test, and to cool down after the test.  The risk of more serious consequences (such as respiratory or heart problems) is diminished by completing the  (HSQ) physical activity readiness questionnaire.

  I have read the information on this form, the brochure “Work Capacity Test” and understand the purpose,
       instructions, and risks of the job related to work capacity test.

 I have read  the information, understood, and truthfully answered the HSQ.

Test to be Taken (check one)  Pack test  Field Test  Walk Test 

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Privacy Statement
The information obtained in the completion of this form is used to help determine whether an individual being considered for wildland firefighting can carry out those duties in a manner that will not place the candidate unduly at risk due to inadequate physical fitness and health.  Its collection and use are covered under Privacy Act System of Records OPM/Govt-10 and are consistent with the provisions of 5 USC 552a (Privacy Act of 1974).
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