Name

Email Address

Phone Number

How many triathlons have you completed? How many triathlons have you completed? 0 1 2 3 More than 3

Are you currently signed up for a race? Are you currently signed up for a race? Yes No

If yes, what is the distance? If yes, what is the distance? Sprint Olympic 70.3 Full Ironman

If yes, what is the date of the race?

On a scale from 1-5 (1 being poor, 5 being great) please answer the following: Swimming Indoors On a scale from 1-5 (1 being poor, 5 being great) please answer the following: Swimming Indoors 1 2 3 4 5

Swimming in Open Water Swimming in Open Water 1 2 3 4 5

Cycling Cycling 1 2 3 4 5

Running Running 1 2 3 4 5

Nutrition Nutrition 1 2 3 4 5

Recovery/Stretching? Recovery/Stretching? 1 2 3 4 5

What are you looking to improve with a coach? (Click all that apply) What are you looking to improve with a coach? (Click all that apply) Finish with a smile on my face Race injury free Get a PR on my next race Be competitive in my age group Other

Anything else you would like me to know?