Athlete Questionnaire
| Please fill it out as completely and detailed as possible. Please copy and paste your information and then email it to speedendcoach@aol.com Your information saves time in evaluating your needs so I can tailor fit your program. After I receive your questionnaire, we will discuss your training plan. All information is confidential. I look forward to hearing from you. |
Name:
Street Address:
Email:
Phone:
Height: Weight: Age: Children:
Occupation and work schedule:
Birthdate:
How busy is your daily life? Do you have a manual labor job?
What are your reasons for seeking personal coaching?
How did you find out about Speed Endurance Coaching?
Goals
What are your short term goals? (next 6 months)
What are your long term goals?
List any specific races and their dates you want to do in the next 12 months:
(please star * the races that are most important to you)
Running History
How many years have you been running:
Age when you started:
Your running history, list your personal bests:
High School, events and times: (if applicable)
College, events and times: (if applicable)
Post Collegiate, events and times:
Masters, events and times: (if applicable)
Race times you've done in the last 12 months:
5k
10k
1/2m
marathon
any other race distances please list:
(please note location of race also)
Describe in detail your last 4 weeks of training:
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Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
Sunday |
Week One
Week One
Week One
Week Four
Briefly describe your last 12 months of training:
How many miles per week do you run presently?
How many miles has been your longest run?
What is your max mileage you have you run in 1 week?
What is your average pace per mile for a moderate effort and easy effort?
For each day: how much time do you have to train and when? (please be detailed as possible so I can tailor fit your new workouts)
Which days of week are the best for longer workouts?
Indicate days where you have traditionally done long runs or hard workouts
Which day of week would you prefer to be a rest day?
What training has worked well for you and what has training has not worked well for you (When have you prospered? When have you failed?)
Health History
Describe any injury problems and when they last occurred:
Do you have any health problems or family history of health problems which might affect or limit you training (ie. heart disease, diabetes, hormonal problems, thyroid, high blood pressure...)?
Are you currently using medications that may affect your running?
Do you have some stressors that I need to know about?
Please describe your diet:
How much quality sleep do you get daily?
Miscellaneous
Are there any problems you have with racing and training that I might need to know about?
Do you own a heart rate monitor? And running watch?
Do you know your max HR?
Do you cross train? (bike, ski, run in the pool etc) How often per week?
Have you tried or enjoy Cross Country Skiing?
What kind of training do you like the most and what kind do you like the least?
Are you interested in a running specific resistance training program?
Do you train with a group or training partner? On what days? For what kind of training and how often?
Anything else you would like to add to help me write your training schedule best for you?
Do I have your permission to post your goal race results on speedendurance.net?
Training Environment
Do you have access to: (please describe)
Health Club
400m track
Trails or dirt roads
Large grass area
Indoor Bike
Cross Country Skiing
Elliptical trainer
Stairstepper
Hilly running course
Dirt or Grass Hill
Pool
Treadmill
Dumb bells
| By sending this information sheet you agree to the following waiver and liability release |
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I hereby attest that I am in good health and capable of participating in a vigorous training program for the purpose of improving my fitness. I understand the risks of participating in any physical activity and the risks associated with running programs in particular. I have consulted a licensed medical doctor to verify my ability to engage in a high level running conditioning program. I have read, voluntarily signed this release and hereby for myself, my heirs executors and assigns, waive, release and hold harmless Nicole Hunt, and Speed Endurance Coaching from any and all claims, demands, liabilities, rights or causes of action arising out of or in connection with participation in activities proscribed by the aforementioned parties |
Please note that athlete must give 5 weeks notice if decide to terminate coaching.
Please type initials to confirm that you read and agree with the above waiver and liability release_____