QUESTIONNAIRE
In order to prepare a program that is specific to you, and to the event you’re working towards, please complete this form.
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Indicates required field
Name
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First
Last
Email
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Phone
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Gender
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Age
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What event are you working towards? Is this your first time at this distance? Do you have a goal for the event: a specific finish time or just to finish? Will you run, run/walk or walk?
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Do you have any other events scheduled prior to this main event?
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Briefly outline your running history. When did you start running? What distances and finish times have you achieved, particularly in the last 18 months?
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What are your current times for 5km, 10km and half marathon, if known?
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What distances, and times, were your longest runs (each week) over the last three weeks? (Please list from oldest long run to most recent long run)
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Please provide a detailed outline of your current weekly exercise schedule on a day-by-day basis, including your running (with distance, time and pace), walking, strength training, cross-training or other regular exercise sessions.
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Going forward, how many days per week can you commit to running? Are there any days that you can’t fit a run in or would prefer to be rest days? What day of the week is most convenient for your longer weekly run?
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Briefly outline any injuries or medical conditions that I need to take into consideration?
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What is your occupation and how many hours per week do you work? Do you work shift work?
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Do you run with a Garmin or GPS watch, or some other device that records your pace, distance and time - or use a Heart Rate Monitor?
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Are there any other considerations that I need to take into account? For example, work trips or holidays where you will be out of your usual schedule.
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Send to Kiri
Kiri Price
Qualified and Experienced Coach
Phone 027-2781118
Email Kiri
Learn more about Kiri's
DEEP WATER RUNNING
classes at AUT Millennium.
QUESTIONNAIRE