Chi Wellness Beauty

1. PARTICIPANT’S PARTICULARS

Name: *

Birthday (mm/dd/yy): *

Gender: *

Marital Status:

Age:

Date:

Address:

Postal Code:

Home Phone:

Cell Phone *

Email *

Occupation:

2. FITNESS LEVEL / INJURIES SURVEY

Running Ability:

Time:

How Many Of Years Of Running Experience?

What Is Your Longest Run In The Last 2 Months?

Time:

Olympic Distance Triathlon: (1.5km S/ 40k B/ 10k R)

Time:

70.3 Distance/Half-Ironman Triathlon: (1.9km S/ 90k B/ 21k R)

Time:

Ironman Triathlon: (3.8km S/ 180k B/ 42k R)

Time:

Swim Ability:

Time:

Cycling Ability:

Time:

What Is Your Strongest Triathlon Discipline?

Time:

How many years of experience in Triathlon?

How many years of experience in Swimming?

How many years of experience in Cycling?

Resting Heart Rate (bpm):

Weight (kg):

Height (m):

Maximum heart rate ever recorded during the last one year:

Any coaching program you joined before or currently subscribing to? (If yes, when and what’s the program):

What is your current running issues? (please elaborate in detail): *

What is your running/triathlon goal in the coming 12 months time (to complete a marathon, IRONMAN, etc)?

Any injuries suffered before / health issues (if there is any) that you like to improve with a holistic practice/active lifestyle approach? Has the injuries healed? *

3. CURRENT ACTIVE LIFESTYLE TRAINING SURVEY

Total Training Hours For Exercise / Week:

Typical Training Details:

Training Details (Which day train which event, what interval sets, long endurance training distance, etc)

4. TARGET RACE EVENT DETAILS FOR CUSTOMISED TRAINING PLAN

Customized/Personalized Training Plan (Target Event Details):

Which event/race:

When is the event/race:

Where is the event/race:

Target/objectives of joining the event/race with a Customised Training:

5. HOLISTIC HEALTH AND SUPPLEMENTS/NUTRITION SURVERY

Chi Wellness is the official distributor of NEFFUL Negative Ion Bedding and Clothing. NEFFUL fabric generates negative ions by friction between clothing and/or skin. It is made in Japan.

Do you know negative ions is good for human health? For general health benefits of negative ions, see this link- https://chiwellnessbeauty.com//about-nefful/negative-ion-benefits

NEFFUL introduction - https://youtu.be/gNFzA0RV_yA

Would you be interested to find out more about NEFFUL Clothing, Bedding and Supports for holistic health?

Supplement you currently use for sports training/recovery/health/wellness. How long you have used it?

Welcome to ChiWellnessBeauty.com – Wellness, Health and Beauty.