Let's begin this journey towards better health! Please answer the questions below, using as much detail as necessary.
let's go!
What's your name? *

Today's date? *

How old are you? *

What's the best phone number to reach you at? *

Have you ever been diagnosed with any of the following?

How long have you been exercising consistently (at least a few days per week)?

Please tell me about any current/previous injuries you have had, running and non-running related. Include type of injury, date, possible cause, how long it lasted, rehab routine, etc.

On average, how many hours of sleep do you get per night?

On average, how much water do you drink per day?

On average, how much alcohol do you drink each week?

Do you smoke?

How would you rate your energy level (low, med, high)? Please explain.

How would you rate your stress level (low, med, high)? Please explain.

Do you travel often for work or pleasure?

What sports did you play in high school and college, if any?

Is your training limited by family or work obligations? Please describe.

Describe a typical training week from the past month. Include miles, paces, specific workouts, cross training activities, etc.

What do you think your strengths are?

What areas of your training do you believe need the most improvement?

What are your expectations of a coach/trainer?

What are your health goals for the next 6 months, 12 months, and 5 years?

What is your long-term, pie-in-the-sky goal for your health?

What defines your success?

That's it! Thank you for filling this out.

Thanks for completing this typeform
Now create your own — it's free, easy, & beautiful
Create a <strong>typeform</strong>
Powered by Typeform