Coaching Intake

About you

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Health

Please explain any yes in the box at the end of this section, and whether it affects your training or racing. If you answer yes to the first, third or sixth question, please check with your doctor before starting a new training plan.

Has a doctor ever told you that you have a heart condition, heart murmur or high blood pressure, or have you had a heart attack?

Yes No

Has anyone in your family had heart disease?

Yes No

Have you ever had chest, shoulder, neck or arm pain, fainted, felt dizzy, or felt unusually out of breath during or after exercise?

Yes No

Do you have diabetes, a thyroid condition or another ongoing health condition?

Yes No

Are you taking any medications?

Yes No

Has a doctor said any condition or injury should limit your exercise?

Yes No

Do you have a current injury, or a past joint, back or knee injury or surgery?

Yes No

Have you had surgery or broken a bone in the last 12 months?

Yes No

Are you pregnant, or have you been in the last 12 months?

Yes No

Do you smoke, or have you smoked?

Yes No, never I quit

Your goals

Your training now

Which sports do you train and race?

Running Trail running Cycling Triathlon Other

Is that week high, low or average for you?

High Average Low

Best day for a rest day

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Strengths and limits

Data and equipment

Do you have a TrainingPeaks account?

Yes No

Fuel and recovery

Anything else

Agreement*

The YogaSoul Participant Waiver is at https://www.yogasoul.org/participant-waiver

My answers are accurate to the best of my knowledge, and I have read and agree to the YogaSoul Participant Waiver.

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