PHYSICAL AGILITY TEST AUTHORIZATION FORM
Each candidate seeking employment as an Anne Arundel County Entry Police Officer
will participate in the following physical agility tests:
1. Abdominal Muscular Endurance - measured by the number of bent-leg sit-ups performed in
one minute.
2. Muscular Endurance of the Upper Body - measured by the number of push-ups performed in
one minute.
3. Cardiovascular Endurance - measured by a 1.5 mile run/walk.
The candidate must achieve the following minimum scores :
TO BE COMPLETED BY CANDIDATE:
CANDIDATE’S NAME (PRINT CLEARLY) : ________________________________________________________
SOCIAL SECURITY NUMBER : _____________________________ DATE OF BIRTH :_____________________
TO BE COMPLETED BY PHYSICIAN :
I certify that I have reviewed the above requirements and it is my opinion that the above-named candidate can
perform the elements of this test without undue risk to himself/herself.
PHYSICIAN’S NAME: __________________________________________________________________________
PHYSICIAN’S ADDRESS: _______________________________________________________________________
PHYSICIAN’S TELEPHONE: ____________________________________________________________________
PHYSICIAN’S ORIGINAL SIGNATURE: __________________________________________________________
PLACE IMPRINT OF DOCTOR’S OFFICE STAMP HERE
This form is valid until August 1, 2021
