Endurance Athlete Questionnaire

Endurance Athlete Questionnaire

Dear Athlete,

Congratulations on choosing Pacific Elite Fitness to design and oversee your training program! The triathlete questionnaire is one of the most important forms you will share with your coach, and will allow thorough development of a personalized training program. Plan on taking 45-60 minutes to complete the form, and do not hesitate to contact your coach if there is additional information you wish to share. After completing, please remember to push the "Submit" button at the bottom of this page. A coach will contact you within 48 hours after completion of this form.

Name: Age: Today's Date:

Primary e-mail address: Secondary e-mail address:

Primary Phone: Secondary Phone:

Mailing Address:

Use the Following Scale to Self-Rate Your Current Skill Level in each Sport (circle one):

.1 = completely inexperienced

.2 = basic knowledge

.3 = average

.4 = above average

.5 = expert

Swim Skill:

.1 .2 .3 .4 .5

Bike Skill:

.1 .2 .3 .4 .5

Describe your cycling history:

Run Skill:

.1 .2 .3 .4 .5

Describe your running history:

The following fields are designed to give your coach an idea of your current and potential training frequency and volume. If your schedule changes from week to week, that's OK. The main focus of this part of the questionnaire is to let your coach know what your current training schedule looks like, and how much potential flexibility you have in your training days/hours. If you feel that you can articulate this information better in an e-mail or phone conversation, let your coach know and then feel free to leave these spaces blank. There will be an opportunity later in the questionnaire to describe your actual workouts.

Current Swim Schedule:

Potential Days/Hours Available for Swimming

Current Bike Schedule:

Potential Days/Hours Available for Cycling:

Current Run Schedule:

Potential Days/Hours Available for Running:

Current Weights/Core/Flexibility Schedule:

Potential Days/Hours Available for Weightlifting/Core Training/Flexibility:

The following questions are designed to give your coach a better idea of how you train and what type of workouts you perform. Be as specific as possible. If you utilize a power meter, heart rate monitor or heart rate training zones, describe your intensities. You can also describe your intensities using a rating of perceived exertion (1=easy, 10=hard) or an adjective (easy, long, hard, fast, short, etc.). Remember to indicate if you currently utilize bricks or combined workouts.

Current Swim Protocol:

Current Bike Protocol:

Current Run Protocol:

Current Weights/Core/Flexibility Protocol:

Describe any other sports in which you currently participate:

The following questions will help your coach determine the equipment and gear you currently use or have access to for training.

Please describe your swimming training and racing gear, including wetsuit, goggle/mask, skinsuit, fins, pull buoy, cap, gloves, socks, elastic swimming bands, aqua belt, etc.

Please describe your cycling training and racing gear, including bike, components, wheels, tires, aerobars, shoes, orthotics, helmet, trainer/roller, etc.

Have you had a professional bike fit? Yes No If so, where?

Please describe your running training and racing gear, including shoe type.

Do you use orthotics? Yes No If so, please describe?

Please describe any special electronic training equipment to which you currently have access (i.e. Garmin Forerunner, Polar HR Monitor, Computrainer, Powermeter, etc):

Please describe your weightlifting/core/flexibility gear, including free weights, bands, medicine balls, stability balls, and cross training equipment

The following questions are designed to give your coach a clear idea of your training environment and access to areas for swimming, cycling, running, and other activities.

Please describe your access to pools and open water swim areas. Please include pool size, open water description (lake, river, ocean) and access limitations (year-round, weekdays only, etc.)

Please describe your biking environment, including information on your “favorite” courses near to your home or work, hill access description, areas to perform time trial tests, wind conditions, etc.

Please describe your running environment, including information on your “favorite” courses near to your home or work, hill access description, areas to perform time trial tests, track access, etc.

The following sections are designed to give your coach an idea of your skill limitations. Please choose the *best possible answer*. Your coach realizes that you may have multiple priorities or limitations, but choose an answer that is most relevant to you. If you would rather describe your limitations in your own words, please write in the space provided.

Swim:

I find it difficult to finish the swim portion of a race.

In choppy open water swims I lose more time than others in my race category.

My swim technique is poor.

My swimming gets slower as the race progresses.

If I start the swim fast I start gasping for air and must slow down more than others in my race category.

At the end of the swim portion I'm unable to speed up to catch those slightly ahead of me.

Other:

Bike:

Just finishing the bike leg of a race is difficult for me.

I am passed by lots of other triathletes on hills.

I'm a masher-I push big gears slowly.

Even on flat courses my bike speed decreases near the end.

As the bike portion of a race gets shorter I do worse relative to those in my category.

In short races, I struggle to get over short power hills.

Other:

Run:

I usually find it difficult to finish long runs.

I run up hills slower than most in my race category.

I bounce up and down more than others when I run.

My running gets slower as the race progresses.

In shorter races, if I go anaerobic I'm forced to slow down.

I almost never win a sprint to the finish line.

Other:

Have you had a VO2 or blood lactate test? Please provide the results if available:

Do you currently complete field testing for lactate threshold, VO2 max, maximum heart rate, etc? If so please describe your field testing procedures and results:

Have you completed any additional tests, such as anaerobic power, resting metabolic rate, etc.? Is so please describe the procedure and results, if available:

What is your height?

Weight? (indicate any disparities between training and racing weight, and if you are attempting to “lose pounds”):

Describe any sport-specific injuries or illnesses you currently have (i.e., knee or shoulder pains, exercise induced asthma, tendinitis, bursitis, diabetes, etc). Be as specific as possible. Include any medications, supplements, or treatments you are currently utilizing to address the problem.

The following questions are designed to help your coach design your racing schedule, familiarize your coach with your desired races, and clearly outline your goals for this racing season. If you have already supplied your coach with a race resume or potential race schedule, you may skip all of this section UNLESS you still need to prioritize your races.

How many years have you competed in races?

Describe your history with sprint distance racing, including approximate number of races completed, race year, race name, any significant race results, etc.

Olympic:

Half-Iron:

Iron:

Other (Ultra, Adventure Racing, Marathon, etc.):

Please list every race that you plan to compete in this year. Prioritize your races as high priority (attempting to win, podium, set a PR, complete as a racing milestone, or crucial to your season’s goals), medium priority (important race that requires a taper, but not crucial to your season’s goals), or low priority (for fun only). Please include any notes (annual “tradition” race, had a DNF last year, must travel significantly to attend, etc.). Copy and include extra sheets if necessary.

Race: Date: Priority:

Notes:

Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

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Race: Date: Priority:

Notes:

YOU’RE ALMOST DONE! The following questions are designed to familiarize your coach with your current nutrition and supplementation practices. Pacific Elite Fitness specializes in assisting athletes with training, racing, and recovery nutrition from a holistic and healthy lifestyle perspective.

What is a typical breakfast?

Lunch?

Dinner?

Describe your snacking habits in between breakfast, lunch, and dinner:

Describe your pre-workout or pre-race nutritional protocol:

Describe your “during the workout” or “during the race” nutritional protocol:

Describe your post-workout or post-race nutritional protocol:

Describe all supplements you are currently using. Include multi-vitamins, sport supplements, electrolytes, and any special pills, capsules or tablets:

How much water do you drink per day, apart from exercise?

How much water do you drink during exercise?

Please describe any food allergies, or intense likes/dislikes:

Please describe any religious, ethical, or logistical limitations regarding nutrition (include information about any current nutritional sponsors):

Use the following section to include any additional nutritional notes for your coach:

FINAL SECTION! Describe what you truly desire from working with a coach. What do you want out of this season? Out of triathlon? Out of life? In other words, why are you sitting here, taking valuable minutes out of your life to complete this form? What are your goals? Be as honest and specific as possible, describing actual races, rankings, or outcomes you want to pursue. You may also use the following section to include any additional general notes for your coach. Include anything that you feel would be helpful that you haven’t yet had a chance to express.

ACTIVITY WAIVER: Please read the following waiver, then, if you agree to the terms, check the box, sign your name, and submit.

Activity: Any and all prescribed workouts and nutritional recommendations from Pacific Elite Fitness or Ben Greenfield, including, but not limited to: outdoor endurance running and sprinting, running, jogging, and walking at a moderate to high effort on all surfaces; stretching and flexibility exercises; body weight and calisthenic exercises, including push-ups, sit-ups, squats and lunges; plyometric and jumping activities including vertical and side-to-side jumping movements on all surfaces; open water and pool swimming; weightlifting; bicycling on and off roads that are open to traffic; bicycling on an indoor trainer; dismounting from bicycle; and any exercise or other activities related to participation in a program recommended by Pacific Elite Fitness or Ben Greenfield. RELEASE OF CLAIMS AND WAIVER OF LIABILITY I understand that this activity requires physical exercise, and I am aware that participation in physical exercise may result in accident or injury, and assume the risk connected with my participation in this activity. I accept all of the risks and the possibility of death, personal injury, property damage and loss resulting from my involvement with this activity. I release Ben Greenfield from any and all liability for any personal injury, death, property damage or loss I may suffer as a result of my participation in this activity, and for any cause whatsoever including negligence on the part of Ben Greenfield. I certify that I am physically capable and fit to participate in this activity and I have no medical conditions or needs that will place me at risk of illness or injury during this activity. Furthermore, I have a physician's approval to exercise. I confirm that I have read over this agreement before signing, that I understand it, and that it will be binding not only on me but also on my heirs, my next of kin, my executors, administrators and assigns. I understand that I have paid or am obligated to pay Ben Greenfield a negotiated fee for this activity, and that under no circumstances is any of this amount refundable. I understand that if under any circumstances I experience lightheadedness, dizziness, muscular pain, excessive fatigue or any other painful or uncomfortable signs that exceed normal exercise fatigue, I am not obligated to continue this activity. Furthermore, I may stop this activity at any time as I desire.

I have completely read, fully understand, and agree to this release of claims and waiver of liability. I also understand that any nutritional recommendations from Pacific Elite Fitness or Ben Greenfield are merely a suggestion and not a prescription:

Please type full name here: