Medical History Questionnaire & Athlete Profile

Athlete Profile
If you are training for a particular event, what and when is it?
What type of physical activities do you currently participate in?
What competitive sports (if any) have you participated in?
Why, when, and how did you get started in running/strength training/fitness?
What is your current weekly training volume (distance, time, days per week) and how long have you been training consistently?
Will you be training by yourself or with others?
What are your short and long-term running/fitness goals?
Does your schedule vary, or is it fairly consistent?
How many days per week can you train?

How many hours do you have available to train each day? If your schedule varies complete this for what might be an average week.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Time

Runners, which is the best day for your long run?
What facilities do you have access to for strength sessions?
Eg. gym, weights at home, nothing
Do you use any kind of heart rate monitor, and if so, what is it?
How competitive are you?
1=not competitive at all, 10=very competitive
How much do you enjoy the intensity of pushing hard while training/racing?
1=not at all, 10=love it
How confident are you in your abilities as a runner/in the gym?
1=not at all confident, 10=very confident
How much do you like to be challenged?
1=not at all, 10=a lot
Should be Empty:

	Yes	No	Give details here
Are you presently under medical care?
Are you taking any medications prescribed by your doctor? (E.g. tablets, ointments, injections or inhalers, including contraceptives and hormone replacement therapy)?
Are you pregnant or is it possible you may be pregnant?
Do you have any allergies?
Have you ever suffered from heart problems, angina, blood pressure problems or stroke?
Do you have a family history of heart disease?
Do you have emphysema?
Do you have high cholesterol?
Have you had surgery in the past year?
Do you drink alcohol? If so, how much per week?
Do you have any metabolic diseases such as diabetes, hyperthyroidism, etc.?
Do you, or have you ever, smoked regularly?
Do you have asthma?
Do you have epilepsy?
Do you have anaemia?
Have you ever suffered from stress fractures?
Have you ever had an injury that caused you to stop exercising for more than a week?

Personal Details