Long View Systems Triathlon Training Survey

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* 1. Please complete the following

Name

Phone #

Age

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* 2. What Wasa Triathlon event are you training for?

Sprint Distance

Olympic Distance

Sprint Team relay Swim

Sprint Team relay Bike

Sprint Team relay Run

OlympicTeam relay Swim

OlympicTeam relay Bike

OlympicTeam relay Run

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* 3. What other events do you have planned for this year? Eg Running races, Bike events, triathlons or other organized events.

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* 4. What is your current level of fitness in the 3 sports

Swim - Can swim for 60 min

Swim - Can swim for 30 min

Swim - Can swim for 15 min

Bike - Can bike for 60 min

Bike - Can bike for 30 min

Bike - Can bike for 15 min

Run - Can run for 60 min

Run - Can run for 30 min

Run - Can run for 15 min

I have completed one or more triathlon

I have never done a triathlon

Other (please specify)

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* 5. What type of Athlete are you?

Swimmer - Experienced strong swimmer

Swimmer - Swam as a kid but not for many years

Swimmer - Just learning

Swim Time: 1500 timed swim 30 min or more

Swim Time: 1500 timed swim 25 - 30 min

Swim Time: 1500 timed swim 23 - 25 min

Swim Time: 1500 timed swim less than 23 min

Bike - Experienced strong biker

Bike - Recreational biker but never entered a race

Bike - Just learning

Run - Experienced strong runner

Run - Recreational runner

Run - Just learning

Other (please comment about your fitness level)

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* 6. How often do you currently exercise?

Swim - 2 or more times a week

Swim - 1 time a week

Swim - Never

Bike - 2 or more a week

Bike - 1 a week

Bike - Never

Run - 2 or more a week

Run - 1 a week

Run - Never

Other (please specify)

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* 7. What days will you be able to train or are already training on?

I will be able to Swim on the following days

I will be able to Bike on the following days

I will be able to Run on the following days

Additional training. Please list type of training. eg weights on Mon and Fri

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* 8. Do you have any current injures or physical limitations that we should be aware of?

Yes

If Yes please list

	Yes	No
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No?	Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No? Yes	Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No? No
Do you feel pain in your chest when you do physical activity? Yes or No	Do you feel pain in your chest when you do physical activity? Yes or No Yes	Do you feel pain in your chest when you do physical activity? Yes or No No
In the past month, have you had chest pain when you were not doing physical activity? Yes or No	In the past month, have you had chest pain when you were not doing physical activity? Yes or No Yes	In the past month, have you had chest pain when you were not doing physical activity? Yes or No No
Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No	Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No Yes	Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No No
Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No	Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No Yes	Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No No
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No	Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No Yes	Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No No
Do you know of any other reason why you should not do physical activity? Yes or No	Do you know of any other reason why you should not do physical activity? Yes or No Yes	Do you know of any other reason why you should not do physical activity? Yes or No No
Is the information you have entered in this questionnaire accurate and true? Note your answer should be YES	Is the information you have entered in this questionnaire accurate and true? Note your answer should be YES Yes	Is the information you have entered in this questionnaire accurate and true? Note your answer should be YES No

Yes

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No?

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No? Yes

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes or No? No

Do you feel pain in your chest when you do physical activity? Yes or No

Do you feel pain in your chest when you do physical activity? Yes or No Yes

Do you feel pain in your chest when you do physical activity? Yes or No No

In the past month, have you had chest pain when you were not doing physical activity? Yes or No

In the past month, have you had chest pain when you were not doing physical activity? Yes or No Yes

In the past month, have you had chest pain when you were not doing physical activity? Yes or No No

Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No

Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No Yes

Do you lose your balance because of dizziness or do you ever lose consciousness? Yes or No No

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No Yes

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes or No No

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No Yes

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes or No No

Do you know of any other reason why you should not do physical activity? Yes or No

Do you know of any other reason why you should not do physical activity? Yes or No Yes

Do you know of any other reason why you should not do physical activity? Yes or No No

Is the information you have entered in this questionnaire accurate and true? Note your answer should be YES

Is the information you have entered in this questionnaire accurate and true? Note your answer should be YES Yes

Is the information you have entered in this questionnaire accurate and true? Note your answer should be YES No

Long View Systems Triathlon Training

Question Title

* 1. Please complete the following

Question Title

* 2. What Wasa Triathlon event are you training for?

Question Title

* 3. What other events do you have planned for this year? Eg Running races, Bike events, triathlons or other organized events.

Question Title

* 4. What is your current level of fitness in the 3 sports

Question Title

* 5. What type of Athlete are you?

Question Title

* 6. How often do you currently exercise?

Question Title

* 7. What days will you be able to train or are already training on?

Question Title

* 8. Do you have any current injures or physical limitations that we should be aware of?

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* 9. Training equipment - what are you currently using?

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* 10. Par - Q (please complete the following questions)