if a man is over 45 then this is a point on the risk scale. a women over 55 is a point on the risk scale. family history of heart disease is a point. less than 6 months of quitting smoking is a point. BMI 32 is a point. If a client has 1 or more risk factors, you may not legally train him or her without a signed consent form from his/her physician. having one point is low risk and doesnt require medical evaluation. 2 is moderate risk and does require evaluation before vigorous exercise. 3 is high risk and needs an evaluation before any exercise.