Training Questionnaire

To get the most out of your training programme, and to develop one specifically for your needs, Fenner’s Total Performance Training (ftptraining) needs to know specific details about you. Please answer the questions as truthfully as possible, as this will enable ftptraining to develop the programme to specifically fit your needs. If you have any queries, please do not hesitate to contact ftptraining.
All information is confidential.

▼ Yours Details
Name: Phone: Mobile:
Address: Post Code: Estate:
Suburb: Age: Date of Birth:
Email:

If you are over 35 and have not exercised for more than 2 years or have a history of heart problems / disease in your family then please consult your physician before embarking on a training programme.

▼ Gender
Male Height: m/ft Mass (Weight): kg

▼ For which specific cycle sport do you require training?


▼ GENERAL HEALTH
Are you in good health?
Yes Other (please explain)
Are you on any medication?
Yes If yes, what type, and what is it for? (BE EXCEEDINGLY SPECIFIC)
Is your physician aware of your sporting activities?
Male

By agreeing to use the services of ftptraining, I understand that I am physically fit, and that I am allowed to take part in strenuous, and maximal cycling exercise. I can in no way can hold ftptraining responsible for any injuries resulting from the use of the training programme provided to me. All training is undertaken at the exerciser's risk.

Signed:
Name:
Date:

▼ PHYSIOLOGICAL CHARACTERISTICS AND TESTS
Have you ever had a maximal aerobic test (e.g., Kingcycle, incremental VO2 max or FTP test)?
Yes If yes, when was it
On what apparatus was the test carried out?
Where was the test conducted?
Do you feel as fit as when the test was conducted?
Yes
What were the results?
Have you had an OBLA, or ‘threshold’ type test?
Yes If yes, what were the results
Have you had a Wingate anaerobic test?
Yes If yes, what were the results
Do you, or your team require testing?
Yes
What is your maximum heart rate, and how was this determined?
What is your body fat percentage, and how was this determined?

▼ TRAINING / RACE CHARACTERISTICS
Please rate your ability at each of these components of cycling on a scale of 1 to 5. Where 5 is excellent, and 1 is poor. Please rate these scores relative to your peers / riders in the same category as yourself.
Climbing
Short rolling hills (typically, up to several minutes duration)
1 3 4 5
Short steep hills (typically, up to several minutes, and > 15%)
1 3 4 5
Moderate climbs (typically, 3 – 10 minutes)
1 3 4 5
Long climbs (typically, 10 – 30 minutes)
1 3 4 5
Very long climbs (> 30 minutes)
1 3 4 5
Sprinting
Maximum bicycle speed
1 3 4 5
Power
1 3 4 5
Strength
1 3 4 5
Accelerations
1 3 4 5
Cadence
1 3 4 5
Sprint tactics
1 3 4 5
Overall cycling ability
Endurance / stamina
1 3 4 5
Bike handling
1 3 4 5
Recovery from intense efforts
1 3 4 5
List your cycling strengths
List your cycling weaknesses
Please state your approximate average heart rates for these events

▼ TRAINING
How long have you been...
Have you only ever cycled, or have you taken part in other competitive sports?
Give some feedback into your background and experience.
Are you currently coached?
Yes If yes, by whom?
And, why contact ftptraining, why leave your other training program provider?
Again give some detail as this will help provide you with the program and service that you need.
▼ CURRENT TRAINING
Think about your current training, during a typical week, and last week. Please describe these two weeks. For both weeks please include:
• The duration per session (time / distance)
• The intensity (HR / power output)
• The terrain (flat / hilly / mountainous / undulating)
• How you felt during and after the ride (e.g., felt good / tired whilst riding / tired afterwards, ran out of energy etc)
• Any other comments (e.g., were you training with a group or friend / alone?)

A TYPICAL WEEK
LAST WEEK

Please state
miles / km) per (week / year)
Does your training currently involve a sport other than cycling?
Weight training Other, please state
▼ RACING
List your four best race results. Event Result Type of race and the winners time.
▼ GOALS
It is important when setting goals that they are suitable for you, and are specific to your needs. When developing your goals with ftptraining it is important that they are structured correctly and that they are within your ability level. Setting goals are vital when structuring a training program so start to get an idea of what you want to achieve in both the short and long term (6 months – 1 Year & 2 – 4 Years)

Over the next 12 months, what are your main racing goals in cycling/Triathlon?
Over the next 12 months, what are your main training goals in cycling/Triathlon?
Over the next 4 years, what are your main long-term goals in cycling/Triathlon?

▼ MENTAL SKILLS
On a scale of 1 – 5, where 5 is always true, 1 is false, and 3 is sometimes, please rate your mental skills ability Training situations.
Training situations
I am motivated to train
1 3 4 5
I give 100% in training
1 3 4 5
During training I am focused
1 3 4 5
I prefer interval type training
1 3 4 5
I prefer endurance type training
1 3 4 5
I don’t like bad weather does not put me off
1 3 4 5
I am willing to make sacrifices to achieve my goals
1 3 4 5

Racing / competition situations
I am always motivated to race
1 3 4 5
Prior to a race I am confident
1 3 4 5
Prior to a race I visualise skills, tactics, etc. of various scenarios
1 3 4 5
Prior to a race I feel calm, and relaxed
1 3 4 5
Prior to a race I feel anxious, and nervous
1 3 4 5
During a race I visualise myself succeeding
1 3 4 5
During racing I am focused
1 3 4 5
During racing I quickly regain my focus
1 3 4 5
I always give 100% in racing, even if it is not going my way
1 3 4 5
I always give 100% even if it hurts
1 3 4 5
After a poor race performance, I quickly regain my composure
1 3 4 5

▼ PLANNING
Please list your scheduled itinerary for racing, holidays, and any breaks that you may have over a period of at least 3 months; listing the event, date, type of race, distance (or time) and level of importance (1=most important; 3=least important):

▼ NUTRITION
What, exactly, did you eat yesterday?

Please describe your usual eating patterns (amounts / what sort of food / do you snack?)
Have you ever had a dietary analysis?
Yes If yes, by whom?
Do you require a dietary analysis?
Yes
Do you use supplements?
Yes If yes, include vitamins / carbohydrate drinks (etc) / performance enhancers / drugs. State the type, make, and frequency of use
Have you considered using IOC legal supplements?
Yes If no, do you require information about their effectiveness? Yes

▼ TRAINING TIME
Please state the typical amount of time you have available to train

▼ OTHER SERVICES
Do you require any other help?
Motivation
Equipment selection
Ergogenic aid
Goal development
Help with racing strategies
Nutrition
Personal consultation
Physiological testing
Other, please explain

▼ FINALLY
Is there anything else that you feel I need to know in order to help your performances. This can be anything. Please allow a minimum of one weeks to receive your training programme as I wish to make an extensive, quality programme that will work for you.

All information is treated as confidential. Do not forget to sign and date the contract. I look forward to helping you achieve your goals.
Mark Fenner www.ftptraining.com
Please print and cut along the line below and sign and return to us by post to:-FTP Training Waiver Form, 271 Emerys Rd, Tapitallee, NSW 2540. This must be done before a training program can be released. Thank you.
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FTP Training Program Waiver

I, ____________________________________ hereby consent to engage voluntarily in exercise prescribed to me by FTP Training. I certify that I am currently in good health and that I have completed a Pre-Training Risk Factor Questionnaire and have provided correct and accurate responses to the questions on this form. I understand that the training program that I will undertake is strenuous and I acknowledge that participation in this training involves certain risks. I understand that by undertaking this training, I voluntarily assume these risks.

In consideration of my following a training program from FTP Training, I hereby release and forever discharge FTP Training, its management, partners, agents, contractors, associates and employees (whether acting within the scope of their employment or not) from any claims, demands or causes of action relating to or arising from my presence or participation in an FTP Training training procedure, which may result in illness or injury to me or even death. I intend this release to bind my heirs, executors, assigns, administrators, personal representatives, and myself.


Signature of the Client:______________________ date:___/___/___/

Signature of Parent/Guardian (If client aged below 18):______________________ date:___/___/___/

FTP Training
In Pursuit of Excellence