E3TS Fitness Assessment Form
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1. Full Name
2. Contact info (Address, phone/mobile and email)?
3. Date of Birth, racing age, racing category?
4. Years involved in endurance sports?
5. Primary goal distance?
Running (10K to Marathon)
Cycling (road, cyclo-cross, etc)
6. Longest event completed last year? (If applicable)
7. How many hours of training per week have you logged for the past 8 weeks?
8. List how many hours available you have for training
List each day Monday to Sunday and the # of hours available next to it
9. What are your season goals?
10. What are your specific A race target(s) goals? (up to 4)
i.e. Timberman 70.3, Vegas 70.3, Ironman Cozumel
11. What are your long term athletic goals?
12. What type of effort-based approach would you like to use; power/pace, heart rate or perceive exertion?
13. Please rank your strengths as they pertain to each sport
5 been the strongest
Not so strong
14. Please share any recent results
(Include triathlons and stand alone races)
15. Do you have any injuries/problems/concerns that affect your athletic training?
16. Have you been cleared by your Primary Care Physician to practice an exercise program?
17. What is your current height and weight?
18. Do you have any medical conditions that we should consider for your program?
19. How did you hear about our services?
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