Microlife BodyGem and MedGem Analyzer Software Form

The Microlife BodyGem and MedGem indirect calorimetry devices include Analyzer software to help setup a weight management plan for your clients.

It’s best to use the Analyzer software when you are with the client, to be able to use the pull-down menus, to select the most appropriate answers.

But for times when you can’t use the Software, here is a link to a printable 1-page Analyzer Software Questionnaire that you can use to gather the information.

It includes the following information.

Analyzer Software Questions

Date: _____________
Name: ________________________________________
Current Height: _____________
Frame Size(measure wrist): _____________
Current Weight: _____________
RMR: _____________

Pregnancy Status: Pregnant: _____ Lactating: _____ Neither: _____
Occupation Activity Level:
Stationary or Office Work: _____
Very light: _____
Light: _____
Moderate: _____
Physical Work: _____
Hard Physical Work: _____

Work Schedule: Hours per week: _____ Work Days: Mon___ Tues___ Wed___ Thur___ Fri___ Sat___ Sun___
Sleep Schedule: Work Day:_____ Non-Work Day:_____

Exercise Plan: Sedentary: _____ Very Light: _____ Light: _____ Moderate:_____ Vigorous:_____ Strenuous:_____
Hours per week:_____ Steps Per Day: _____

Weight Plan: Target Weight: ______________ Target Date: _____________

Additional Notes:

 

 

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