Running Technique Coach: Running Questionnaire

Thank you for making the commitment to work with us on your running technique. We just need you to fill out this questionnaire to help us know as much as possible about your running history and background before we begin working together.

Thank you for supporting our business.

Running history questionnaire

Name:
E-mail:
Mobile:
Contact me by:

Please note your preferred appointment days and time. The coaching & assessment consultation lasts for one hour. The Meyers Place studio has change, locker & shower facilities. We will contact you directly to confirm the appointment time. Other locations by special arrangement only.

Select location & time:
Preferred day(s):
Any other information about your booking we need to know:

Health check

If you answer YES to any of the questions below, it is important for you to discuss these with your Doctor before commencing a running program. Your Doctor will be able to decide if there are any medical reasons why you should not be running.

Are you a male over 35 years or female over 45 years of age: *
Has your Doctor ever said that you have heart trouble?: *
Have you ever suffered from a stroke?: *
Do you frequently have pains in your chest or heart region?: *
Do you often feel faint or have dizzy spells?: *
Has your Doctor ever told you that you blood pressure is too high or low?: *
Do you have any other health issues that may impact on your running?

Running injury history

Please complete the rest of this form to the best of your knowledge. It will provide us with a valuable insight into your running history and help you get the most out of your coaching consultation.

Please describe any areas that regularly get sore or injured during running::
Are you currently injured? *
What happens to any pain as you warm-up?

Current level of running fitness and training program

How many km per week on average have you run in the last 6 months? *
How many days do you usually run per week?
Describe what sort of hard training sessions you usually do:
What sort of surfaces do you usually run on?
Running goals and aspirations: *
Describe any target races or events you want to complete this year:
Describe any recent race, fun run or best times over your preferred distances:

Running shoe history and orthotics

Please bring your regular running shoe(s) and your orthotics if you wear these for any running.

Describe the shoe makes and models you are currently wearing:
Describe any issues or experiences with shoes you feel are worth noting:
Do you wear orthotics or inserts when running?

My feet

Do your feet have any unusual attributes?
Describe any attributes of your feet relevant to your running or shoe fit:
Do you ever run barefoot?
If you run barefoot, describe how much volume you do and on what surfaces:

My running technique and body

Have you ever been told you are a certain type of runner? Describe:
I've been told I:
Please indicate your usual foot-strike pattern:
Do you think you land heavily or over-stride?
On an easy run, what is your normal stride rate or cadence?
Describe which muscles get tired first when training and racing:
Do you use any technique prompts or mental cues when running?
Any other information you think we need to know:

Strength training

I have experience with:
Have you are are you doing any strength training work? If yes please describe:
Our partners at Fitline have developed a 12 week package of personal training for runners working with us. Would you like Fitline to contact you about this offer?

Terms & conditions

Our terms and conditions of service. We can’t guarantee you won’t get sore or injured when making improvements to your running technique. We will give you as much information as possible about how to make changes in a sensible and cautious way. However, you need to acknowledge and accept that there are risks of getting sore or injured from making changes to your running technique.  If you do not accept these risks please do not use this Service.

I have read, understand and accept the terms and conditions of service. *

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