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  • Athlete Profile Questionnaire

  • Please fill out all the question below with as much detail as possible. All information is confidentail and will be stored securely. 

     

  • The Basics

  • Gender
  • What is the best method to contact you?
  •  -

  • Your other-than-athletics life (optional)

  • Married?

  • Health History

  • Please complete every question. If you need to elaborate i.e. 'list medications used', please use the blank field at the bottom of this section

  • 1. Have you or anyone in your family had coronary artery disease?*
  • 2. Do you ever have chest, shoulder, neck, or arm pains after exercise?*
  • 3. Have you ever fainted, felt dizzy, or unusually winded after exercise?*
  • 4. Has a doctor said that your blood pressure is too high or uncontrolled?*
  • 5. Has a doctor ever said you have heart trouble, a heart murmur, or that you have had a heart attack?*
  • 6. Are you diabetic, have a thyroid condition, or any chronic condition?*
  • 7. Are you using any medication? List them at the bottom of this section.*
  • 8. Is your cholesterol level high? What's your cholesterol count?*
  • 9. Have you ever had a complete physical exam including stress test on a treadmill or ergometer? When?*
  • 10. Do you have any conditions that a doctor says may limit your exercise?*
  • 11. Have you ever smoked? When did you quit?
  • 12. Have you ever had a joint or back disorder or any current injury?*
  • 13. Have you had surgery in the last 12 month?*
  • 14. Are you now, or have you been pregnant in the last three months?*

  • Athletic History

  • 2. Do you currently have a strength training routine?
  •    
  • 4. Have you ever had an exercise related injury which caused you to stop exercising for a week or more?

  • Current Athletic Information

  • 1. Have you planned what races you will compete in for this or next season?

  • 2. What are your three most important goals? Rank them 1-2-3.

  • 4b. Is the above schedule high, normal, or low for you?
  • 8. Do you have a bike trainer?
  • 9. Multisport and/or Cycling: Do you have a cycle computer with cadence function?
  • 10. Multisport only: Do you have access to a track?
  • 11. Multisport only: Do you run with a running club?
  • 14. Multisport only: Do you have access to a masters swimming program?
  • Total:  0/  1000 
  • 18. Do you own a heart rate monitor?*
  • 19. How familiar are you with heart rate monitors?*
  • 20. Do you own a Computrainer or other power meter device?

  • Limiters

  • In order to focus your training most efficiently, we need to determine your limiters: those aspects of fitness that are limiting your current performances. Please take a few moments to assess your abilities on a score of 1-5.
    1 = among the worst in my race category
    3 = about the same as others in my race category
    5 = among the best in my race category
    See descriptions of each ability below.

  • Rows

  • Definitions:

    • Endurance is the ability to delay the onset and reduce the effects of fatigue, implies an aerobic level of conditioning.
    • Speed is your current race fitness and ability to train and race at high speed.
    • Skills is the ability to move effectively while swimming, biking, or running. A measure of economy and technique.
    • Muscular Endurance is the ability of the muscles to maintain a relatively high force load for a prolonged time. A combination of force and endurance.
    • Anaerobic Endurance is the ability to resist fatigue at very high efforts when arm or leg turnover is rapid.
    • Power is the ability to apply maximum force quickly

  • Miscellaneous Factors

  • Rows

  • Diet

  • Comments and Questions

  • Athlete Waiver

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