NAME

WORK #

YES NO

WHEN WAS YOUR FIRST TRATHLON?

Month January February March April May June July August September October November December Year before 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Month January February March April May June July August September October November December Year before 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

WHEN DID YOU FIRST STARTING RUNNING?

Month January February March April May June July August September October November December Year before 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

CYCLING?

Month January February March April May June July August September October November December Year before 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

SWIMMING?

Month January February March April May June July August September October November December Year before 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

LIST YOUR BEST PERSONAL RECORDS AND TOP FINISHES:

HOW MANY TIMES & MILES DO YOU RUN WEEKLY?

Times    Miles

HOW MANY TIMES AND MILES DO YOU BIKE WEEKLEY

Times    Miles

HOW MANY TIMES AND YARDS DO YOU SWIM WEEKLY?

Times    Yards

HOW MANY WORKOUTS PER WEEK DOES YOUR HEART RATE GP ABOVE 80% OF YOUR MAX?

DO YOU BELONG TO A MASTERS SWIM PROGRAM?

YES NO

DO YOU TAKE YOUR PULSE REGULARLY?

YES NO

DO YOU WEAR A HEART RATE MONITOR?

YES NO

DO YOU LIVE IN AN AREA WITH HILLS?

YES NO

HOW LONG IS YOUR LONGEST RUN DURING AN AVERAGE MONTH?

HOW LONG IS YOUR LONGEST RIDE DURING AN AVERAGE MONTH?

HOW FAR IN ADVANCE TO YOU PLAN FOR YOUR RACES?

WHAT ARE YOUR TIME COMMITMENTS:

WEEK DAY

DO YOU FEEL YOUR TIME SPENT TRAINING INTEGRATS WELL INTO YOUR LIFE IN GENERAL?

YES NO

DESCRIBE YOUR WORKOUTS IN TERMS OF TIME ALLOTMENTS,
(as "I run before work, I commute to the office, I swim after work, I ride on the weekends.")

AGE      SEX   Sex Female Male   HEIGHT     WEIGHT  

ON A SCALE 1 TO 10 WHAT IS YOU HEALTH GENERALLY?

0 1 2 3 4 5

HAVE YOU HAD ANY HEALTH PROBLEMS OF SIGNIFICANCE SINCE ADULTHOOD?

YES NO

WHAT IS THE NUMBER OF HOURS YOU SLEEP A NIGHT?

DESCRIBE BELOW ANY THERAPIES(MESSAGE, CHIROPRACTIC) YOU RECIEVE REGULARLY:

WHAT KIND OF BIKE DO YOU RIDE?

WHAT TYPE OF BARS DO YOU RIDE WITH?

Not applicable Areo Bars Pursuit bars Road Race Bars

DESCRIBE BELOW ANY WAY THE GEOMETRY POSITION IS ALTERED FROM ITS ORIGINAL STATE:

WHAT KIND OF SHOES DO YOU RUN IN?

DO YOU RUN IN ORTHOTICS?

YES NO

DESCRIBE THE TERRAIN ON WHICH YOU RUN, INCLUDING WHETHER YOU DO OR DONT REGULARLY RUN OFF-ROAD:

DO YOU CURRENTLY TRAIN UNDER A COACH?

YES NO

DESCRIBE BELOW ANY COACHING PHILOSOPHIES TO WHICH YOU ADHERE:

DESCRIBE BELOW HOW YOU CURRENTLY DETERMINE WHAT YOUR TRAINING REGIMEN WILL BE: