Unit title Evidence/assessment method Date, time and place Any reasonable of assessment adjustments negotiated number Instructing exercise with 12 written session plan referred patients 13 observed session delivery (L/503/7491) 14 written worksheet Anatomy and physiology for 15 multiple-choice test: paper-based/online exercise and health (tutor/assessor to delete as applicable) (A/600/9051) Applying the principles of 16 multiple-choice test: paper-based/online nutrition to a physical (tutor/assessor to delete as applicable) activity programme (L/600/9054) 17 written knowledge questions and case study Learner’s name: Learner’s signature: Date: Assessor’s name: Assessor’s signature: Date: IQA’s name: IQA’s signature: Date:
Unit title number Evidence/assessment method Date, time and place of assessment Any reasonable adjustments negotiated Instructing exercise with referred patients (L/503/7491) 12 13 14 written session plan observed session delivery written worksheet Anatomy and physiology for exercise and health (A/600/9051) 15 multiple-choice test: paper-based/online (tutor/assessor to delete as applicable) Applying the principles of nutrition to a physical activity programme (L/600/9054) 16 17 multiple-choice test: paper-based/online (tutor/assessor to delete as applicable) written knowledge questions and case study Learner’s name: Learner’s signature: Date: Assessor’s name: Assessor’s signature: Date: IQA’s name: IQA’s signature: Date:
Exercise-Referral-LAR-Fillable.docx