ATHLETE QUESTIONNAIRE

Dear Athlete,

Congratulations on choosing RTA to design and oversee your training program! The Athlete Questionnaire is one of the most important forms you will share with your coach, and will allow thorough development of a personalized training program. Plan on taking ~20-30 minutes to complete the form, and do not hesitate to contact your coach if there is additional information you wish to share. After completing, please remember to push the "Submit" button at the bottom of this page.

*We recommend NOT using your phone to complete this.

ATHLETE QUESTIONNAIRE

CONTACT INFORMATION

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Email *

Cell Phone Number *

Emergency Contact

Primary Email *

Cell Phone Number *

How Did You Hear About Ridgewood Tri Athlete? *

MEDICAL HISTORY

Birthday (MM/DD/YY) *

Choose One *

Male Female

Height *

Weight (current) *

Is this your normal weight? *

Resting Heart Rate *

Resting Blood Pressure *

Conditions/Chronic diseases

Cardiovascular

Are you suffering from a heart Condition (heart attack, angina, irregular beat, hole in heart etc.)? *

Yes No

Do you feel pain in the chest when performing physical activity? *

Yes No

Do you suffer from high or low Blood Pressure? *

Yes No

Are you taking medication to control your blood pressure or a heart condition? *

Yes No

Do you have a back or joint problem that could be made worse through physical activity? *

Yes No

Do you knowingly suffer from Diabetes? *

Yes No

Do you suffer from respiratory Illness (asthma, bronchitis, emphysema) or have shortness of breath with mild exertion? *

Yes No

Are you under medical treatment for any illness? *

Yes No

For Ladies Only: Are you pregnant (or have you had a child in the last 3 months)? *

Yes No

LIFESTYLE

Family *

Work *

Hobbies *

Travel *

Amount of Vacation / Time off *

Number of hours/week exercising (currently) *

Preferred Time of Day exercising *

Access to pools / water *

Comment *

Access to biking (outdoor/indoor) *

Access to running (outdoor/indoor) *

Exercise Schedule/Availability

This section is VERY IMPORTANT as it will allow your coach to create a schedule that fits your life as best as possible.

At the minimum, please indicate the "Total Time Available" to train for each day. Then, please do you best to fill in the remaining blanks. This will allow your coach to truly create a schedule that works best for you.

When completing the section below, please keep in mind any TAVEL TIME to and from the pool or gym, for example. In other words, just because you may have 1.5 hours to ride your bike before work, doesn't mean you have that same 1.5 hours to swim in the morning when accounting for travel time to and from the gym.

Please refer to the example below for guidance. If you still have questions, don't hesitate to contact your coach.

EXAMPLE

MONDAY

Total Time Available (Monday) *

Swim (Monday MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Monday MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Monday MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Monday MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

TUESDAY

Total Time Available (Tuesday) *

Swim (Tuesday MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Tuesday MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Tuesday MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Tuesday MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

WEDNESDAY

Total Time Available (Wednesday) *

Swim (Wednesday MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Wednesday MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Wednesday MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Wednesday MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

THURSDAY

Total Time Available (Thurs) *

Swim (Thurs MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Thurs MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Thurs MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Thurs MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

FRIDAY

Total Time Available (Friday) *

Swim (Friday MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Friday MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Friday MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Friday MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

SATURDAY

Total Time Available (Saturday) *

Swim (Saturday MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Saturday MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Saturday MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Saturday MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

SUNDAY

Total Time Available (Sunday) *

Swim (Sunday MORNING) *

Swim (AFTERNOON) *

Swim (EVENING) *

Bike (Sunday MORNING) *

Bike (AFTERNOON) *

Bike (EVENING) *

Run (Sunday MORNING) *

Run (AFTERNOON) *

Run (EVENING) *

Weights (Sunday MORNING) *

Weights (AFTERNOON) *

Weights (EVENING) *

DIETARY

Number meals/day *

Calorie intake (if known) *

Modified diet/restrictions *

Food preferences *

Dietary supplements (vitamins, herbs, minerals, protein, replacements) *

PSYCHOLOGICAL

[ 1 = Poor | 2 = Fair | 3 = Good | 4 = Very Good | 5= Excellent ]

TRIATHLON HISTORY

History: Date 1st triathlon completed *

Number of triathlons completed *

Longest distance completed - what - total time - splits *

Other endurance events *

Qualifications/Honors *

GOALS for this season and beyond *

ATHLETIC HISTORY (other then Triathlon)

Other endurance events

What *

When *

Time/Ranking *

What *

When *

Time/Ranking *

What *

When *

Time/Ranking *

What *

When *

Time/Ranking *

What *

When *

Time/Ranking *

What *

When *

Time/Ranking *

Other types of exercise/ physical activities *

Type of organized sports (current) *

Types of organized sports (past) *

TRIATHLONS & OTHER EVENTS FOR SEASON

Race Name *

Race Date *

Race Distance *

Priority *

Race Name *

Race Date *

Race Distance *

Priority *

Race Name *

Race Date *

Race Distance *

Priority *

Race Name *

Race Date *

Race Distance *

Priority *

Any other races or events? *

SWIMMING

Years swimming? *

Total weekly distance *

Weekly frequency *

Longest swim (to date) *

Organized program? *

Planned workouts? *

Swim capability *

What do you think are your limiters? *

What do you think are your strengths? *

What equipment do you own? *

Access to pool/water *

BIKING

Years biking? *

Total weekly distance *

Weekly frequency *

Longest bike (to date) *

Organized program? Racing club? *

Planned workouts? *

Bike capability (time/distances) *

What do you think are your limiters? *

What do you think are your strengths? *

What equipment do you own? *

Access to riding (indoor, outdoor) *

Do you ride in a group? *

RUNNING

Years running? *

Total weekly distance *

Weekly frequency *

Longest run (to date) *

Organized program? Racing club? *

Planned workouts? *

Run capability (time/distances) *

What do you think are your limiters? *

What do you think are your strengths? *

What equipment do you own? *

Access to running (outside, inside) *

Strength and Conditioning

Describe your current strength and conditioning program (include organized classes, frequency and duration). *

Which of the following types of equipment do you have access to? *

Does your occupation require extended periods of sitting? *

Does your occupation require extended periods of repetitive movements? (If yes, please explain) *

Does your occupation require you to wear shoes with a heel (dress shoes)? *

FINALLY! ...

What motivates you? *

What are the 3 most important goals in order of importance to you? *

At the end of the season, how will we know if we were successful? What is the single most important thing we must accomplish? *

Submit