Questionnaire Coaching One on One
Please complete the questionnaire below for Coaching Services start-up. Thanks! Simon Says Cycling
Full Name
Your answer
Email
Your answer
Telephone
Your answer
What's your age?
Your answer
Height
Your answer
Weight
Your answer
Goal Weight
Your answer
Preferred method of communication:
Best times/days for communication:
Your answer
What Level Coaching Service do you want to sign-up at?
Do you have a Training Peaks account?
How many hours can you train consistently each week (be realistic)?
Your answer
How many years have you been cycling?
Your answer
Do your compete in races (indicate category)?
Your answer
Do you train with a power meter and heart rate monitor?
Whats your maximum heart rate (last year) or threshold heart rate?
Your answer
Whats your current best 20 minute power (last 3-6 months)?
Your answer
Whats your current best 5 minute power (last 3-6 months)?
Your answer
Whats your current best 1 minute power (last 3-6 months)?
Your answer
Whats your current best 5 sec power (last 3-6 months)?
Your answer
What are your cycling strengths?
Your answer
What are your improvement goals physically?
Your answer
What are your improvement goals related to bike handling, skill and strategy?
Your answer
What are your improvement goals related to to the mental side like confidence, discipline, fears, habits etc.?
Your answer
What are your improvement goals related to your weight and diet?
Your answer
Is there a race goal or event goal/trip we are working towards (please list dates)?
Your answer
What is your ultimate cycling goal?
Your answer
Any health issues or injuries that affect you?
Your answer
Are you cleared by a doctor for strenuous exercise?
Your answer
Please describe in detail what a typical training week looks like for you with the days your train, the hours, and the type of training:
Your answer
Please list race dates, event dates, travel etc. that should be included in your training for the next 2-4 weeks:
Your answer
When would you like to start with coaching (date)?
Your answer
What day and time works for a start-up consultation over the phone/skype (please provide 2-3 options).
Your answer
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