Pre-Program Questionnaire

Please use your answers below to tell program organizers about yourself: your contact information, your current fitness level, and your goals, needs, and concerns. Thanks!

Your Name(Required)
First Last
Email Address(Required)
Phone Number(Required)
How would you describe your running, jogging, or walking experience?(Required)
- Transitioner (non-athlete to novice)
- Launcher (novice to beginner)
- Practitioner (beginner to intermediate)
- Racer (intermediate to advanced racer)
- Master (advanced to coach/teacher)
Choose one only
How many years of running, jogging, or walking experience have you completed?(Required)
- 0-1
- 1-2
- 3-4
- 5-6
- 7 or more
What is your current fitness level?(Required)
- Not fit
- Little fitness
- Somewhat fit, almost fit, or becoming fit
- Ample fitness
- Abundant fitness
During the past three months, how many times per week have you done running, jogging, or walking workouts of 30 minutes or more)?(Required)
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 7+
Are you currently injured, i.e., experiencing pain during or after exercise? Please indicate the level of pain on the scale below:(Required)
- N/A (I’m not experiencing pain)
- Tender
- Twinge
- Ache
- Sore
- Severe

Please sequence the following in order of their importance to you on the following scale: 1 very important; 2 important; 3 somewhat important; 4 minimal importance; 5 not important. It’s okay to have ties. And you may sequence all or few choices.

	Not Important	Minimal Importance	Somewhat important	Important	Very Important
Make new friends
Increase my fitness
Finish a race (of any distance)
Perform my best in a race
Understand the training process (for personal training purposes).
Eat sensibly (for health, fitness or weight management purposes).
Train consistently and without injury.
Enjoy my fitness activities.
Have more life energy.
Have better sleep.
Become healthy.
Improve my health-related numbers.
Decrease my need for disease-related medicine.

Your questions or comments:
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