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Client Questionaire

 

Personal:
Name:
Address:
DOB:
email:
Operating system
(ie) - Windows etc:
Ph: Home:
Work:
Mobile:
Occupation:
Work stress rate 1-5:
Work hours per week:
Married/Single?
Children?

 

Athletic Background:
Years in endurance sports?
Which sports?
Years in multisport?
List your best results & times:
 

Your Current Schedule:
Do you keep a training diary?
If yes can you copy a typical week & 1 race week?
How many days per week can you train?
How many days per week do you train now?
How many hours per week overall do you have to train?
 

Note: Fill this section out as detailed as possible with breakdowns of all training availability.
How many hours per week day?
Mourning: Hours
Afternoon: Hours
 
How many hours per weekend?
Mourning: Hours
Afternoon: Hours
 
What have been your longest sessions in the last month?
Swim: Hours
Cycle: Hours
Run: Hours

 

Current Fitness:

Rate current fitness: 1 Best - 10 Worst
 
Max pulse rate if known?
Running: bpm
Cycling: bpm
Anaerobic threshold pulse rate if known?
Running: bpm
Cycling: bpm
 
Do you train with a heart rate monitor?
 
List your Personal Best for the following if known
RUNNING:
5km's hh:mm:ss
Max heart rate:
Date:
10km's hh:mm:ss
Max heart rate:
Date:
42.2km's hh:mm:ss
Max heart rate:
Date:

Could you put dates on the latest results please:

 
CYCLING:
40km's hh:mm:ss
Max heart rate:
Date:
90km's hh:mm:ss
Max heart rate:
Date:
180km's hh:mm:ss
Max heart rate:
Date:

Could you put dates on the latest results please:

 
SWIMMING:
200M hh:mm:ss
Max heart rate:
Date:
400M hh:mm:ss
Max heart rate:
Date:
1500M hh:mm:ss
Max heart rate:
Date:
3,800M hh:mm:ss
Max heart rate:
Date:

Could you put dates on the latest results please:

 

Training Terrain:

Rides Available: Please check  
 
FLATS
ROLLING HILLS
STEEP HILLS
MOUNTAINS
LONG HILLS
 
 
Do you have a turbo trainer? Type mag or wind?
 
Which sport are you training primarily for?
Triathlon: short course
long course
Iron man
Duathlon:
Running:
Swimming:
Cycling:
Fitness:
 

 

Goals:
Please list the races that you have planned for the season or future/list races & dates:
 
What are you long term goals for the sport?

 

Medical:
Have you ever suffered from a heart condition?
 
Do you suffer allergies?
If so which allergies do you suffer from?
 
Do you ever get numb feet while exersizing?
Have you ever passed out while exersizing?
Any injury's currently?
How is your immunity? Do you get lots of flu's/colds etc?
Do you suffer from diabetes or asthma?
 
Please list any other medical matters you would like me to know about:
 
Anything else that would be relevant to the coaching program - Please list: