Athlete Intake Form - Breno Melo Endurance Coaching

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ONBOARDING

BRENO MELO
ENDURANCE COACHING

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

Estimated time: 15-20 minutes

Contact Information

Full Name * Date of Birth * Today's Date *

Email Address * Mobile Phone *

Street Address

City State/Province ZIP/Postal Code

Best Time to Call Instagram Handle Strava Profile

Racing Season & Goals

List your target races for the upcoming season. Priority levels: A = Primary goals, B = Important races, C = Training races

Personal Records

Enter your personal best times for each distance. Leave blank if not applicable.

Sprint Distance

Swim Bike Run Overall When Where

Olympic Distance

Swim Bike Run Overall When Where

Half Ironman (70.3)

Swim Bike Run Overall When Where

Ironman (140.6)

Swim Bike Run Overall When Where

Distance	Swim	Bike	Run	Overall	When	Where
Sprint
Olympic
Half Ironman (70.3)
Ironman (140.6)

Individual Sport PRs

500 yd/m Swim 1000 yd/m Swim 1650 yd Swim (1 mile) 40K TT Bike Century Bike (100mi) FTP (Watts) 5K Run 10K Run Half Marathon Marathon VO2 Max CSS (per 100m)

Medical Information

Current Weight Weight 5 Years Ago Height

Last Physical Exam Resting Heart Rate Blood Pressure

Doctor Support for Training

Yes No

Medical History

Have you or immediate family members ever experienced:

Nutrition & Wellness

Average Sleep Per Night Sleep Quality (1-10) Stress Level (1-10)

General Eating Habits

Do you take supplements or vitamins?

Yes No

Fruits & Vegetables Per Day Daily Caffeine Intake Daily Water Intake

Alcohol Consumption Smoking/Tobacco Use

Sports Nutrition Habits

Equipment & Logistics

Swim Equipment

Bike Equipment

Run Equipment

Training Availability

Indicate your typical weekly availability for training. Be realistic about your time constraints.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Morning 5am-12pm
Afternoon 12pm-5pm
Evening 5pm-10pm

Average Training Hours Per Week Non-Training Commitments

Non-Triathlon Responsibilities

Current Training Volume

Swim (hrs/week) Bike (hrs/week) Run (hrs/week)

Years in Triathlon Preferred Training Time

Coaching & Mental Skills

Rate your current abilities from 1-10 (1 = Poor, 10 = Excellent). If rating is below 5, please explain in comments.

Skill	Rating	Comments (if <5)

Athletic Background Summary Your Strengths as an Athlete Skills You Most Want to Improve This Season Preferred Coaching Style Previous Coaching Experience Why Are You Hiring a Coach Now? Goals 2 & 5 Years From Now Anything Else We Should Know?

Permission to use your photos & race results on social media / bmelocoaching.com? *

Yes No

By submitting this form, you agree to be contacted by Breno Melo Endurance Coaching regarding your training inquiry.

Onboarding

BRENO MELO
ENDURANCE COACHING

Contact Information

Racing Season & Goals

Personal Records

Individual Sport PRs

Medical Information

Medical History

Nutrition & Wellness

Equipment & Logistics

Swim Equipment

Bike Equipment

Run Equipment

Training Availability

Current Training Volume

Coaching & Mental Skills

Breno's Assistant