New Athlete

Start-up Questionnaire

Let’s get going!

Congratulations for taking the first step toward improving your athletic performance. This survey will give me the information needed to design a training program that meets your goals & matches your physiology.

Don’t worry if you do not have all the information – fill in the data to the best of your ability.

This is not a pass or fail!

First and Last Name

Date of Birth

Mobile Phone Number

Business Number

Address

Address Line 2

City

State

Zip Code

Country

Occupation

Height

Weight

Marital Status

Children

What is you level of Experience?

Beginner - Your goal is to finish the event.

Intermediate - Your goal is to set a personal best in this race.

Advanced - Your goal is to place in your age group or category.

Training Availability

3 - 5 days per week - 45 to 90 minutes per day to train

5 - 6 days per week - 60 to 120 minutes per day to train

6 - 7 days per week - 60 to 180 minutes per day to train

Current Fitness Level - Overall - (based on last 2 months)

Sedentary - Not much of any training at all.

Somewhat active - about 2-3 workouts per week

Consistent - Active most days with a day off here and there

Active - 6 to 7 workouts per week, I'm on fire.

Current Fitness Level - SWIM - Avg. Swim Pace per workout?

Not sure?

4 Minute per 100 meters - 4 minutes to swim 4 down and back laps

3 Minute per 100 meters - 3 minutes to swim 4 down and back laps

2 Minute per 100 meters - 2 minutes to swim 4 down and back laps

2 Minutes or less per 100 meters - 2 minutes or less to swim 4 laps

Current Fitness Level - RUN - Longest run distance and time

Current Training Schedule - List the days you currently train and what you do on those days below

MEDICAL - Do you have any current medical conditions? If so, describe

MEDICAL - Do you currently take any medications? Please list them if so.

MEDICAL - Are you allergic to any medication?

MEDICAL - Are you hypersensitive to insect stings?

Yes

ATHLETIC HISTORY - What is your background in endurance sports?

ATHLETIC HISTORY - Which sports and for how long?

ATHLETIC HISTORY - Do you currently compete in a sport? If so what?

ATHLETIC HISTORY - Do you currently swim competitivly?

Yes

ATHLETIC HISTORY - Do you currently compete in running races?

Yes

ATHLETIC HISTORY - Do you currently race bicycles?

Yes

ATHLETIC HISTORY - List any MULTISPORT events in the last 6 months.

ATHLETIC HISTORY - List any SWIMMING events in the last 6 months.

ATHLETIC HISTORY - List any BIKING events in the last 6 months.

ATHLETIC HISTORY - List any RUNNING events in the last 6 months.

ATHLETIC HISTORY - RUNNING - What is your PR (or estimated) for 5k, 10k, 15k, 1/2 Marathon, Marathon? ?

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Start-up Questionnaire

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