Start Your Journey - Form
Potential New Client Questionnaire
Age (number only - example: 54)
Prefer not to say
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)
Life has gotten in the way
Regular and Consistent
Struggling to find the time
Battling some injuries and niggles
It's a major part of my life and I don't miss a day
I can't find the rhythm
I'm exploring a variety of new workouts
Injury free and seeing improvements
Bored with my routine
Putting in the time but not seeing much improvement
No idea where to get started
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?
What type(s) of Coaching/Guidance do you imagine you would respond to best? (check any/all that apply)
Direct- just tell me what to do so I can do it
Help me build confidence
Give me gentle guidance and direction
Be my drill sergeant
Be my cheerleader
Be my companion on this journey
Be clear and honest and tell me like it is
Don't be too tough on me, I don't respond well to criticism and negative feedback
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?
Yes, please follow up and let me know how to get started.
No, I'm not ready for those changes, yet.
Maybe, I really want those things for myself, but I want to think about it.
Send me a copy of my responses.
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