Team Rohr Powerlifting Questionnaire
Beginning Questionnaire for Team Rohr customized powerlifting training.
Name *
Your answer
Date of Birth *
MM/DD/YYYY
MM
/
DD
/
YYYY
You will need a google e-mail address to access google docs. Please provide your google e-mail that you would like me to use. *
If you don't have a google e-mail, please provide the best e-mail to contact you.
Your answer
Current Bodyweight *
Your answer
Desired Bodyweight *
If different from current bodyweight
Your answer
Do you have any injuries/disabilities that might limit you training for powerlifting? *
If you answered "yes" please list and explain here
Your answer
Please rate your ability to "grind out" weights. *
Do you have the ability to grind out weights (slow) or does it have to be fast in order to finish the lift?
Can Grind
Medium
If not fast, I fail
Squat
Bench Press
Deadlift
Where is your sticking point on each lift? *
Where do you fail on each lift if you fail?
Bottom
Middle
Top
Squat
Bench Press
Deadlift
Please check all that apply to your squat technique. *
Required
Please check all that apply to your bench technique *
Required
Please check all that apply to your deadlift technique *
Required
Do you have specific days that need to be training days? *
Please check all that apply
Required
How many total days/week can you commit to a training program (with Team Rohr and on your own)? *
If you will be training with Team Rohr in person, which days will that be?
How much time do you have to devote to a training session? *
Number of years lifting *
Number of years competing *
Current Squat Max *
Raw and Equipped (if applicable)
Your answer
Current Bench Press Max *
Raw and Equipped (if applicable)
Your answer
Current Deadlift Max *
Raw and Equipped (if applicable)
Your answer
If training at your own facility (other than Team Rohr's facility), please list your available equipment.
Example: Incline Bench, Dumbbells, Power Cage, Chains, etc.
Your answer
Please describe any training plans you have followed in the past *
If you've never followed one, please put "none"
Your answer
How did they work for you & What did you like/dislike about them? *
If not applicable, put "n/a"
Your answer
When would you like your programming to begin? *
At least 7 days notice is required.
MM
/
DD
/
YYYY
Do you have an upcoming competition? If so, what meet and when is it? Will you be competing raw or equipped? *
If no competition, put "none"
Your answer
Please list any additional comments/info that will help me in designing a program for you
Your answer
Please post links to any videos of your training or competing that you have available
Prefer Youtube
Your answer
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