Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
City
Age
What sparked your interest in hiring a running coach and what do you hope to achieve in working with one?
Are you looking to train for a specific race/s? If so, what race/s and when?
If training for a specific race, are you trying to run a certain time? If so, what are you aiming for?
Are you interested in virtual or in-person coaching?
Which of the below best describes your current fitness?
I'm at the couch stage of the couch-to-marathonOption 1
I've historically been physically fit, but am currently not in my prime
I've lost some fitness because of an injury, but am ready to come back strong
I'm at the beginning of my fitness journey, and am gaining momentum and motivation
I feel physically fit and I'm ready to level up and add more of a challenge
I am in great shape and I'm now looking to get even faster and stronger
Other
What is your current weekly mileage?
Zero - I'm not running at all
Less than 10 miles
10-20 miles
20-30 miles
30-40 miles
40-50 miles
50+ miles
If you are currently running, how many miles is your longest run of the week?
Beyond running, how else do you stay in shape? i.e. biking, yoga, strength, etc.
How many years have you been running?
I've never ran before
Less than a year
1-3 years
3-5 years
5-10 years
10+ years
What race distances have you completed?
If applicable, please share your PR and most recent time for each distance as well as the years raced.
Do you have an injury history? If so, please list the injury, when it happened, and if it is ongoing.
Do you have any health concerns that I should be aware of? If so, please list and explain:
If you listed anything above, have you consulted your doctor and/or physical therapist and been cleared to participate in an exercise program? If you have any limitations, please explain:
We'll get a bit deeper on the call, but for now, is there anything else you'd like to share?
