New Athlete Questionnaire

Contact Information

Full Name: Date of Birth: Today's Date: Email Address: Mobile Phone: Street Address: City: State/Province: ZIP/Postal Code: Best Times to Call: Instagram Handle: Strava Profile Link:

Racing Season & Goals

Please list your upcoming events, prioritizing them from A (most important) to C (least important).

Event Name	Date	Priority (A-C)	Goals
		A B C
		A B C
		A B C
		A B C
		A B C
		A B C
		A B C
		A B C

Long-Term Athletic Goals (Beyond This Season):

Medical Information

Current Weight (lbs/kg):		Weight 5 Years Ago (lbs/kg):
Height (ft/in or cm):		Blood Pressure:
Last Physical Check-up:		Resting Heart Rate:

Do you have full support from your doctors to participate in a strenuous training program?

Yes No

Medical Conditions

Please indicate if you or an immediate family member have experienced any of the following conditions:

Heart Problems or Chest Pains:	Yes No
Asthma or Breathing Issues:	Yes No
Diabetes:	Yes No
Hypertension (High Blood Pressure):	Yes No
Other Medical Conditions:	Yes No

Any other condition that could affect performance (e.g., smoking, allergies)?

Injury History

Please indicate if you have experienced any of the following injuries:

Fractures of any bones:	Yes No
Sprains or Strains:	Yes No
Other Injuries:	Yes No

Personal Records

Please provide your personal best times for the following distances (if applicable):

Distance	Swim Split	Bike Split	Run Split	Overall Time	Date	Location
5K
10K
Half-Marathon (13.1 miles)
Marathon (26.2 miles)
Sprint Triathlon
Olympic Triathlon
Half-Ironman
Ironman

Equipment & Logistics

Please indicate which of the following equipment you have:

Swimming Equipment

Equipment	Do You Have It?	Details (Brand, Model, etc.)
Wetsuit	Yes No
Goggles	Yes No
Swim Cap	Yes No
Kickboard	Yes No
Pull Buoy	Yes No
Fins	Yes No
Masters Swim	Yes No

Cycling Equipment

Equipment	Do You Have It?	Details (Brand, Model, etc.)
Bike	Yes No
Helmet	Yes No
Cycling Shoes	Yes No
Clipless Pedals	Yes No
Bike Repair Kit	Yes No
Cycling Computer	Yes No
Road Bike	Yes No	Front Gearing: Select Front Gearing 48/35T 50/37T 52/39T 54/41T Rear Gearing: Select Rear Gearing 10-26T 10-28T 10-30T 10-33T 10-36T Crank-Arm Size: Select Crank-Arm Size 165mm 167mm 170mm 172.5mm 175mm
Triathlon Bike	Yes No	Front Gearing: Select Front Gearing 48/35T 50/37T 52/39T 54/41T Rear Gearing: Select Rear Gearing 10-26T 10-28T 10-30T 10-33T 10-36T Crank-Arm Size: Select Crank-Arm Size 165mm 167mm 170mm 172.5mm 175mm
Triathlon Aero Helmet	Yes No
Indoor Trainer	Yes No
Training Software	Zwift TrainerRoad

Running Equipment

Equipment	Do You Have It?	Details (Brand, Model, etc.)
Running Shoes	Yes No
GPS Watch	Yes No
Hydration Pack	Yes No
Running Belt	Yes No
Foam Roller	Yes No
Heart Rate Monitor	Yes No

Typical Weekly Schedule

Please provide your typical weekly schedule, including work, family, and other commitments.

Time	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Morning
Afternoon
Evening

Please list any other responsibilities or regular activities:

Mental Skills Assessment

On a scale of 1 to 10 (1 = Poor, 5 = Average, 10 = Excellent), please rate yourself on the following mental skills. For any score less than 5, please provide details.

Confidence:
Pain Tolerance:
Focus:
Motivation:
Stress Management:

Coaching Questionnaire

What type of coaching style works best for you? Have you been coached before? If so, what worked well and what didn't? Why have you decided to involve a coach at this time? What are your athletic goals for the next 2 years? What are your athletic goals for the next 5 years? Is there anything else you would like your coach to know? Do you give us permission to use your photos and race information on social media and www.brenoamelo.com?