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Client Questionnaire
We would love to hear from you! Please fill out this form and we will get in touch with you shortly.
Name
First
Last
Email
Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone
Work or Cell
At which number should we call you?
Best time to reach you?
How would you like to receive workouts?
Email
Fax
US Mail
Occupation
Hours worked weekly
hours
Marital Status
Single
Married
Divorced
Widowed
Children
Date of Birth
MM
DD
YYYY
Weight
lbs
Height
How long have you been running/riding/skiing?
If you race how long have you been racing?
Have you worked with a coach before?
yes
no
If so who?
Do you keep or have you kept a training log?
yes
no
Do you or have you done weight training for your sport?
yes
no
Waking Pulse
bpm
Do you train with a heart rate monitor and/or power meter?
yes
no
If you train with a heart rate monitor, what is your max heart rate?
bpm
Current training schedule, activity, duration, intensity.
Is this current schedule maintenance, foundation, preparation, competition?
maintenance
foundation
preparation
competition
What has been your longest workout the past three weeks?
hours
How many hours do you have weekly to train?
hours
Which is the best day for you to take off or use as recovery?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What are your strengths?
What would do you see as your weakness, areas that need attention?
What are you goals?
Do you have or access to indoor training – treadmills/turbo trainers?
yes
no
What is your favorite type of race/or event? Why?
What is your favorite race/event? Why?
What is your greatest memory competing in a race or participating in an event?
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