Online Coaching

Online Coaching Form

Email: *
Name: *
Address:
City:
Province/State:
Country:
Phone:
Fax:

Aerobic (long distance) & Anaerobic (speed work) Conditioning
What days are you available to train and how much time are you able to train on these days?
(check all available days)
Days Available Duration Available AM / PM
Monday Yes No AM PM
Tuesday Yes No AM PM
Wednesday Yes No AM PM
Thursday Yes No AM PM
Friday Yes No AM PM
Saturday Yes No AM PM
Sunday Yes No AM PM
Preferred days OFF:


Conditioning Activities
What conditioning activities are you currently involved in?
(Indicate the activity and how long per day, i.e. running, cycling, rowing...)
Current Training Days Activity Time Per Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
1) Other (please specify):
2) Other (please specify):
3) Other (please specify):


Strength Conditioning
If you strength train, please indicate your training days:

Mon. Tues. Wed. Thurs. Fri. Sat. Sun.

Please list all exercises you do during a workout session:
(please enter all workout sessions including sets and reps)

Session 1
Exercise Sets x Reps
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)

Session 2
Exercise Sets x Reps
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)

Session 3
Exercise Sets x Reps
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)


Gym / Training facility
Are you a member of a gym/training facility? Yes No

If yes, please write in the name of the facility you train at:

Indicate the equipment you have access to train with:
(check all applicable equipment)

Aerobic Conditioning Strength Training
Computrainers
Treadmills
Rowing Machines
Stationary Bikes
Elliptical Trainers
Stair Climbers

Other (please specify):

1)
2)
3)

Olympic Weights
Dumbells
Selectorized Machines
Cable Machines
Medicine Balls
Swiss Ball

Other (please specify):

1)
2)
3)



Injuries

Please indicate any previous or current injuries that might limit your training:

Type of Injury Injury Status
Rehabilitated Still in Rehab
Rehabilitated Still in Rehab
Rehabilitated Still in Rehab


Training Goals

What are your goals for training this year?

1)

2)

3)

4)


Events

Please list any planned events/races you are planning to enter in the future along with the dates:

Event Event Date
1)
2)
3)


Comments

Please enter any more information you feel will help us in designing your program:



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