Client pre-participation screening procedures should be _____.

Including fitness testing at the first meeting conflates pre-participation screening with fitness assessment, and fitness testing is not a criterion that defines a screening procedure itself.

Physician pre-approval is not a universal requirement for all client risk levels, and cost effectiveness alone without validity or time efficiency is an incomplete standard.

Validity ensures the screening tool accurately identifies health risk; cost effectiveness makes the process accessible for clients and sustainable for facilities; time efficiency ensures clients complete the process without deterrence. Together, these three criteria define a screening protocol that is clinically appropriate and operationally viable without imposing unnecessary barriers.

Requiring physician pre-approval for all clients is overly restrictive beyond standard guidelines, and incorporating fitness testing at the first meeting confuses screening with assessment activities.