FITNESS/TRAINING SURVEY FORM

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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:

Running Trainning Details:

Run Which Day

Weekly Total Run Distance/Time

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

Swim Trainning Details:

Times/Week Which Day

Weekly Total Distance/Time

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

Bike Trainning Details:

Times/Week Which Day

Weekly Total Distance/Time

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

Others Trainning Details:

Times/Week Which Day

Weekly Total Distance/Time

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

Any sports/games during younger days? If yes, what is it?

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. AVAILABLE TIME FOR CUSTOMISED TRAINING

Running

How many times per week?

How many hours per session?

Which Day?

Swimming

How many times per week?

How many hours per session?

Which day?

Cycling

How many hours per session?

Which Day?

Additional Notes:

Which Rudy Project eyewear/helmet you like to know more? (https://chiwellnessbeauty.com//aarons-gear/rudy-project)

6. 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.