Please fill out the following intake form as accurately as possible. The information you provide here will speed the process of setting you up for your training program. We will most likely have questions for you that will be answered during our first session together as well as having you complete a full health history and waiver.

If you have any questions don't hesitate to call us at: 503-332-8710 or via email at info@speedshotracing.com.

Look forward to hearing from you shortly,

SpeedSHOT | Racing & Coaching Services

Contact Information
Name
Address
Email
Phone
Preferred Time to Contact
Desired Level of Coaching
Premium: Elite: Pro: Other:
Athletic History & Current Fitness
How many years have you been racing / training (in triathlon as well as other sports) - please detail:
Please list your current season results (Note if it was a PR(personal record)):
Did you keep a training log over the past season (whether in paper or digital form)?		Yes No
If digital or online, and you would like Coach Mark to review - please include website, login, and password:
What are your threshold paces (PR's) for:
	Swim (1.5k):
	Bike (40k):
	Run (10k):
What are your percieved strengths?
What are your percieved weaknesses?
Have you been tested (VO2, Lactate, Field tests) in the past year?		Yes No
Would you like to schedule testing?		Yes No
Do you have results?		Yes No
Where did you have it done / by who?
Have you had a bike fit completed in the last year?		Yes No
By whom?
Injury History
Do you have any injuries we should be aware of (current, within the last year, or that may affect your mobility / training in the future)? If so, please detail.
Goals
What are your key races this year?
	1.
	2.
	3.
	4.
	5.
Do you have any performance goals this year (ie. time goals, qualification goals, race management goals)?
What limiters would you like to address in your training?
Coaching History and Season Expectations
With prior coaching - What worked well?
With prior coaching - what did not work well?
With whom did you have your coaching relationship? (note - the reason for asking is to better understand application of training based on their philosophy, not to critique the coach).
What do you expect to accomplish this season?
What do you expect out of your coaching relationship this season?
Lifestyle
What is your day job?
Are you married?		Yes No
..and with kids?		Yes No
Time available to train (hours per week)
What Training Facilities & Equipment Available? (gym, pool, indoor trainer, powertap/computrainer, etc)
Gym Membership		Yes No
Pool Access		Yes No
Indoor Trainer		Yes No
Power Monitoring (i.e. Powertap or Computrainer or SRM)		Yes No
Other Facilities Available:
Nutritional History
Are you on any specific diet or limitations? If so what?
Typical Post-workout nutrition?
Comments / Concerns / Considerations
Is there anything else that you'd like use to take under consideration regarding your goals, training plans, etc?

Click the "Submit" button to submit your information. We will contact you within 48 hours to follow-up to get you started.