Run Coaching Intake Form
Monthly Online Coaching for Runners:
- $120/month
- Personalized Run Programming + Strength Circuits
- Weekly access to Jess via phone touch point + Final Surge app
- Monthly Newsletter
- Monthly Live Zoom Q+A

Please complete this form and she will be in touch with you regarding next steps.
Have more questions? You can reach Jess at
Email *
Name (first, last) *
Date of Birth *
Phone Number *
E-Mail *
Address *
Occupation (Company, Job Title) *
I am interested in: *
Have you worked with a run coach before? *
Why do you want to work with a run coach? *
What is your current fitness routine? Please include any workouts you currently participate in on a weekly basis and if there are days of the week you prefer to run, rest, or cross-train. *
How would you describe your relationship with running? *
How many years have you been running? *
What is your highest training volume in miles/week? Did that feel too little? too much? just right? *
Please list your race times and distances from the past 12 months. *
If applicable: What are your Personal Records's in: 1 mile, 5K, 10K, 1/2 Mar, Marathon? *
What is the most important race for you in the next 6 months? 12 months? Do you have a specific goal? time goal? *
What tracking device, if any, do you use for your training? *
What app, if any, do you use to record your runs? *
Have you had or do you have any previous or lingering injuries, medical conditions, or take any medications that could affect your ability to train? *
If yes to the question above, have you been cleared by your Doctor to work out? Can you provide a Doctor's clearance note if requested? *
Please describe any significant injuries you've had in the past 6 months. *
Jessica currently bills her clients through venmo or PayPal. Please include your username: *
How did you hear about coaching with Jess? *
Lastly, is there any thing else you want Jess to know that could affect your training, or ability to train consistently?
A copy of your responses will be emailed to the address you provided.
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