Athlete Runner's Questionnaire

In order to help me plan a fitness/running program for you, it is necessary to evaluate some of the health and lifestyle history, as well as your present running fitness. Please answer to the best of your ability. Your information will be kept confidential and used only in helping make recommendations for a fitness/run program.

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Birthday

Month

Day

Year

Height & Weight:

Emergency Contact (Name & Phone)

Current state of health:

Current medications, (including herbals if any)

If currently sick or injured, describe difficulty and date of onset:

Health risks (i.e. family history, chronic disease, etc.)

Running history (check all that apply)

Fitness and fun

Recreational or Social Racing

Training for multi-sport (triathlon, dualathon)

Racing for improved performance

Racing for awards (overall, age group, Boston qualifying)

Other

How long have you been running?

Would you consider yourself:

Novice runner

Experienced runner

Other

Running race experience

None

Novice

Experienced

How many miles per week have you averaged over the past three months?

Have you ever done "speed" workouts, interval training, or "effort" sessions?

Yes

No

If the answer is yes, please give me the details...

Do you have a run watch to track interval paces? If so, what kind?

Select all you will be running on:

Treadmill

Pavement

Indoor Track

Outdoor Track

Recent or chronic injuries:

Describe any problems with previous training or racing:

Most recent racing results, including distance, pace/time, and date:

Short Describe your current training goals-- what are you trying to accomplish and by when (i.e. race date & goal)?

Running personal bests that you have run in the last 3 years (1 mile, 5K, 10K, half marathon, marathon, other):

What is your current "conversational" pace? (pace you can run comfortably and hold a conversation)

What fitness activities besides running do you want to continue to do?

Choose what you currently have access to for strength training & mobility/stability training **Note: if you do not have BODi, specific strength training and mobility workouts will not be written into your plan. BODi membership is purchased separately.

BODi member (active)

None, will purchase BODi

Other

How many days per week are you willing to dedicate to your run training?

3

4

5

6

IN ADDITION to your run workouts, how many days per week are you willing to strength train? (you will have at least one mandatory rest/recovery day)

2

3

4

Anything else you'd like to share with me?

CUSTOM RUN TRAINING PLANS

5K - 4 week plan only$40

10K - 8 week plan only$70

Half Marathon - 12 week plan only$100

Full Marathon - 16 week plan only$130

Select the run plan that you would like to purchase. Please note that this is for the run plan only. Strength training, mobility, stability, recovery workouts are separate. If you do NOT currently have an active BODi membership, you will need to purchase that separately. You may use your own strength training/mobility program, however it will not be integrated in with your run plan.

RUN COACHING OPTIONS

Training4momlife Community ***FREE W/PLAN PURCHASE***$0

4 weeks of "open chat" run coaching & plan modifying$40

8 weeks of "open chat" run coaching & plan modifying$80

12 weeks of "open chat" run coaching & plan modifying$120

16 weeks of "open chat" run coaching & plan modifying$160

The Training4momlife Community is complimentary with purchase of a run plan. "Open chat" run coaching entails open Q&A and weekly chat check-ins via direct messaging, as well as plan modifications as needed (i.e. if you become injured or need to modify the schedule for any other reason).

Let's run stronger together!

Athlete Runner's Questionnaire

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