Heart rate difference experiment for IA - subject form

In this experiment, you will be asked to run on a treadmill for 5 minutes, and your heart rate will be recorded multiple times within the experiment. 

If you are doing this experiment on your own, instructions will be included in the next section, read the instructions before beginning the experiment.

Information you will have to disclose in this experiment:

  • Age 

  • Weight and height 

  • Any health conditions 

  • Smoking status (optional)

  • How many times a week they participate in physical activity 

  • How long are they participating in it approximately

  • Caffeine intake 

  • Anxiety level (optional)

please note that responses are anonymous
Safety measures: 

  • Ensure subjects are familliar with use of treadmills, showing them the emergency stop in case of accidents. 

  • Ensure subjects have no health issues that prevent them from preforming physical activity.

Ethical measures: 

  • Subject’s name will not be disclosed or recorded. Contact information will be kept off records. 

  • Any personal or health information will be confidential and records of it will be destroyed after data analysis. 

  • Subject’s participation and results will be confidential outside of data collection. 

  • Subject is informed that they cannot withdraw their information in the future due to project submission.

  • Subjects will be informed of all parts of the experiment to ensure their ability to withdraw before the occurrence of distress or discomfort. 

Data will be stored in a secured spreadsheet that will not include subject’s name, but rather a number assigned to each subject. Once IA is submitted, spreadsheet will be deleted.


please ensure you read this thoroughly, ensuring you know the information needed. This questionnaire is to be answered during the conduct of the experiment.
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How old are you? *
What is your weight? (in Kg) *
What is your height (In Cm) *
What is your gender?  *
What is your smoking status? (optional) please specify if you are currently smoking, how often you smoke, what you smoke (vape, hookah, cigar etc.) If you have previously smoked please specify the same detail with addition to how long it has been since you smoked. Please provide as much detail as possible.

What health conditions do you have? (eg. asthma, heart issues, etc.) please list all of them and give any additional detail.  *
on a scale of  1-10 how nervous/anxious are you? (optional)
not at all
very very
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are you familiar with the use of treadmills?  *
When was the last time you consumed caffeine? *
how often do you engage in physical activity? *
After thoroughly reading the ethical considerations of this experiment. Do you consent to your information being recorded and shared? *
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