New Athlete Questionnaire

New Athlete Questionnaire

Please take some time to fill out this questionnaire completely. The more information you can provide, the better your training program design will be.

Contact Info

Racing Season & Goals
Racing Season & Goals
Event Name Date Priority (A-C) Goals
Medical Information Form
MEDICAL INFORMATION
Current weight: Weight 5 years ago:
Last Physical Check-up: Resting HR:
Height: Blood Pressure:
Do you have full support from your doctors to participate in a strenuous multisport training program?
Have you or a member of your immediate family ever experienced any of the following medical conditions?
Heart problems or chest pains?
Diabetes mellitus?
Gastrointestinal problems?
Seizures/migraines of any kind?
Asthma?
Anxiety/panic attacks?
Any other condition that could affect performance (e.g. smoking)?
Have you ever experienced any of the following injuries?
Fractures of any bones?
Ruptures of muscles/ligaments?
Surgery that might affect sport performance?
Blackouts, dizziness, or memory loss?
Overuse injuries, such as IT Band Syndrome?
Personal Records
Personal Records
Distance Swim Split Bike Split Run Split Overall When? Where?
Olympic
Half-iron
Ironman
500yd/m Swim
1000yd/m Swim
1650yd (1mi) Swim
40km TT Bike
Century Bike (100mi)
5km Run
10km Run
13.1mi Run
26.2mi Run
Equipment & Logistics Table
EQUIPMENT & LOGISTICS
Item Options Details
Wetsuit? Yes No
Fins? Yes No
Kickboard? Yes No
Hand paddles? Yes No
Pull buoy? Yes No
Masters Team? Yes No
Bike #1 Road Tri
Bike #2 Road Tri
Front Chain Rings
Rear Cassette Yes No
Power Meter? Yes No
Heart Rate? Yes No
GPS? Yes No
Cadence/metre? Yes No
Treadmill access? Yes No
Track access? Yes No
Trail access? Yes No
Running club/team? Yes No
TrainingPeaks account? Yes No
WKO+ software? Yes No
Tri club/team? Yes No
Medicine ball? Yes No
Swiss ball? Yes No
Yoga class, Pilates? Yes No
Free weights, gym machines? Yes No
XC skiing or snowshoe? Yes No
Other? Yes No
Other? Yes No
A Typical Week Schedule
Time Please indicate your sport scheduling preferences, key workouts & off days, and the time you have available for training.
MORNING
LUNCH
EVENING
TOTAL HRS
RESPONSIBILITIES
Coaching & Mental Skills
COACHING & MENTAL SKILLS
Please rank yourself for these mental skills relative to athletes in your age-division.
(1=Poor, 5=Average, 10=Excellent) For any score lower than 5, please describe or give an example.
Confidence
Pain tolerance
Setting daily goals
Visualization skills
Focus during practice
Focus during racing
Self-talk
Dealing with setbacks
Mental toughness
Sense of humor
Relaxation
Coachability
Coaching Questionnaire

Thank you for completing this questionnaire! Please return it via email.

We will review this questionnaire with you via phone, or in-person meeting as soon as possible.