Athlete Questionnaire
In order to help us plan a fitness/athletic program for you, it is necessary to evaluate some of your health and lifestyle history, as well as your present running fitness level. Please answer to the best of your ability. Your information will be kept confidential and used only in helping make recommendations for a fitness program.
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Email *
First Name *
Middle Name
Last Name *
Street Address *
City *
State *
Zip Code *
Birth Date *
MM
/
DD
/
YYYY
Gender *
Height *
Weight *
Phone *
Emergency Contact Name *
Emergency Contact Phone *
Medications *
Any current injuries or illness? *
Recent running injuries? If so, when? *
Do you have your doctor's clearance to start an exercise/running program? *
How long have you been running? *
What type of runner would you consider yourself? *
How many miles per week have you averaged over the past 3 months? *
Describe your recent training during the last six (6) weeks - include: longest run, typical weekly mileage, speed work, type of courses (flat, hill, track, etc.), additional cross training (biking, swimming, weights, etc.). *
Have you ever done "Speed" workouts, interval training, or effort sessions? *
Racing Experience - List the races you've completed in the last six (6) months. Include the name, distance, completion time, and date of each race. *
Personal Bests -List your best performances at applicable distances (5k, 10k, Half, Full marathon). Include the name, distance, completion time, and date of each race. *
Running Interests? *
Required
List your running and racing goals (future races, dates, and goal times). *
Describe any previous problems with racing or training that you've had. *
Why are you seeking personal coaching? *
What days of the week are you typically available to run? *
Not Available
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
A.M. (before noon)
P.M. (afternoon or evening)
Do you run with at GPS device? If so, what brand? *
Required
How did you hear about us? *
Did someone refer you to us? If so, please provide their name.
Please provide your social media handles (Facebook, Twitter, Instagram, etc.): *
Would you like to subscribe to our mailing list? *
Please list any other questions, comments, or concerns that you have.
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