Start Your Journey - Form
Potential New Client Questionnaire
Email *
Last Name
First Name
Age (number only - example: 54)
Clear selection
Preferred method of Communication
Phone Number (required only if you prefer text communication)
Running History (brief summary)
Past Races or Events
Current Typical Running/Training Week (days, hours, type of workouts, etc)
Describe your last 3 Months of Training (check any/all that you feel apply)
Is there a specific program or plan you are currently following? If so, which one?
Past or Current Injuries or Health Issues or Concerns (list any/all that apply)
Short Term Goal(s) for Running
Long Term Goal(s) for Running
Other Health, Wellness, and Life Goals (Examples: Weight Loss, Organizing Time, Strength, Flexibility, Healthier Diet, More Active Lifestyle, Etc)
What do you feel have been, currently are, or could potentially be your biggest obstacle(s) on your health and wellness journey?
Are you following any specific Diet or Nutrition Plan? If so, which?
Do you include any strength training in your regimen? If so, what does it include and what is the frequency?
Have you ever worked with a Running Coach or Trainer in the past?
Clear selection
What type(s) of Coaching/Guidance do you imagine you would respond to best? (check any/all that apply)
Why do you run or want to start running?
Why start this Journey now?
Do you want to run short term or are you looking to make it part of a positive lifelong Journey?
What are you hoping to get out of the Coaching process?
Are you ready to embark on an exciting journey of more happiness, a healthy and active lifestyle, better life/work/family balance, and an overall sense of well being?
Clear selection
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy