Sean Bell Run Coaching - Medical Profile
This form must be filled out before your 1-1 coach kick off call and starting your 2 week premium trial of Sean Bell Run Coaching.
Full Name
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You identify as:
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Male
Female
Non-Binary
Date of Birth
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Β -
Day
Β -
Month
Year
Date
Email
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Phone Number
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Country and State / Region (We like to know where you are based to connect you with our other runners in your area) - Feel free to write N/A if not interested.
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1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?
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Yes
No
2. Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise?
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Yes
No
3. Do you ever feel faint or have spells of dizziness during physical activity/exercise that causes you to lose balance?
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Yes
No
4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
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Yes
No
5. If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months?
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Yes
No
Not Diabetic
6. Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise?
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Yes
No
7. Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity or exercise?
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Yes
No
Because you answered 'YES' to one or more of questions 1 to 7:
βͺ 7B. Have you been given clearance by your GP or appropriate allied health professional to undertake physical activity/exercise?
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Yes
No
8. Are you currently exercising?
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Yes
No
9. Other than where you have indicated above, have you been hospitalised recently?
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Yes
No
βͺ 9B. Please tell us a little more about why?
10. Are you currently pregnant?
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Yes
No
βͺ 10B. How many weeks?
11. Have you given birth?
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Yes
No
βͺ 11B. Please tell us how long ago and if you experienced any postnatal issues (e.g. abdominal separation, pelvic floor, pelvic instability, carpal tunnel syndrome, etc.)
Emergency Contact (Name & Relationship to you):
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Emergency Contact's Phone Number
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Health, Fitness & Background Questions
π Tell us about your lifetime training history (e.g. have you played other sports before, and if so, how long for etc.)
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π Tell us about your injury history (have you had any serious injuries we need to be aware of? Do they still affect your training?Β And have you had any operations or surgeries?
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Β π Tell us your current training split (please share everything you are currently doing with your fitness Monday - Sunday) and if there are any non-negotiables for you. E.G. Every Tuesday morning you run with your local run club?
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π How often do you currently run?
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Please Select
I don't run
1 x per week
2 x per week
3 x per week
4 x per week
5 x per week
6+ x per week
π Average weekly kilometres?
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Please Select
Less than 5km per week
6 - 10km per week
11 - 20km per week
21 - 30km per week
31 - 40km per week
41+ km per week
π Longest run in the past 4 weeks?
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Please Select
Less than 5km
6 - 10km
11 - 20km
More than 21km
π Your biggest struggles with training right now?Β
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π Please add a link to your Strava here for your coach to review your recent training
π What is your best 5K time and when was it?
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π What is your estimated best 5K time currently? (For Premium members, I use this information to personalise your suggested training paces)
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π What is your best 10K time and when was it? Please write unsure if you don't know your time or N/A if you haven't run a 10K.
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π What is your best half marathon time and when was it? Please write unsure if you don't know your time or N/A if you haven't run a half marathon.
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π What is your best marathon time and when was it? Please write unsure if you don't know your time or N/A if you haven't run a marathon.
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π Your short term goals (0-6 months), and longer term goals (6-12 months +) with running?Β
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π Are there any races you already know you would like to do this year? Please share as much information as possible: e.g. Date, Location, Distance
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Work & Daily Load
How you work day to day changes how much training your body can handle. Why? I need to coach someone with a very physically demanding job like a concreter differently to someone working in an office.
π What do you do for work? (Feel free to answer as job title or role)
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πWhat does a typical week look like for you? (Hours, shifts, early mornings, travel, unpredictable weeks, etc.)
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Family & Life Context
Your life outside training matters. Why? I need to coach a single professional differently to a parent juggling work, kids, and limited recovery.
π What does your current home life look like? (Single, partnered, kids etc.)
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π Do you have regular family or caregiving responsibilities that affect your time or energy?
Please Select
Yes
No
If yes, briefly explain (e.g. full time with kids, school runs etc.)
π How predictable is your weekly routine?
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Please Select
Very predictable (almost identical week to week)
Somewhat predictable
Changes week to week
Sleep, Stress & Recovery
Training stress + life stress = total stress. This helps me balance your training so you stay healthy and consistent.
π On average, how many hours of sleep do you get per night?
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π How would you rate your current overall stress levels? (1β10)
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π Is there anything going on right now, or anything specific about your lifestyle or situation, that I should be aware of when planning your training?
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Final details
Thanks for your time and detail with this form so far, this helps us get the most out of working together
π How did you first hear about Sean Bell Run Coaching?
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Please Select
Instagram
Facebook
TikTok
YouTube
Podcast β The Long Run With Sean Bell
Speaking event / Keynote
Bali Hope Ultra
Google Search
Email newsletter
Word of mouth / Current or Past Member Referral
Other
π Who referred you?
π Please specify
π Best Postal Address (Optional) - Occasionally used for member surprises
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
π Unisex T-shirt size (Optional) - Only used if needed
Please Select
Extra Small (XS)
Small (S)
Medium (M)
Large (L)
Extra Large (XL)
2XL
3XL
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