Name
*
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email
*
Date of Birth
*
MM
DD
YYYY
General background
*
Occupation, student, marital status, family
Height (ft/in)
Weight (lbs)
Ideal/Goal Weight (lbs)
Hours of sleep (average)
Ideal hours of sleep
Athletic background
How would you describe yourself as an athlete? Did you grow up participating in any sports?
How long have you been running?
Have you ever worked with a coach?
If yes, what was your experience like?
Do you do any stretching?
If yes, please describe
List any other sports you participate in, if any
Training history
What type of training have you done (days per week, hours, intensity)
Past race history
Last 12 months
Planned races
Next 12 months, indicate if any are a A, B or C race (priority)
Strengths and Weaknesses
Be honest here, this is where I really get to know you.
Swim Strength
Weak
Comfortable
Strong
Bike Strength
Weak
Comfortable
Strong
Run Strength
Weak
Comfortable
Strong
Time commitment (daily/weekly)
Include any days and time periods you can not train. Please include preferred day for long runs. This is not in stone and can change if your schedule changes.
Do you have any physical concerns or injuries?
Do you have any medical issues, not related to injury?
Do you have a gym membership?
If yes, how often do you go and what do you do there?
What equipment do you use?
Watch, power meter, shoes, compression?
What are your goals as a runner?
Be detailed here as it will help guide the program.
What is your nutrition like?
What are you looking to get from having a coach?
What type of program are you considering?
*
5k
10k
Half-marathon
Marathon
Sprint Tri
Olympic Tri
Half Ironman
Ironman
Sport Specific Preparation
Custom
Please share anything else you think I should know.
