* = Required field
Date of birth (dd/mm/yyyy)
Please describe with as much detail as possible your history of health related matters and injuries. Also explain any current injuries that may prevent you from training at 100% effort or if you are currently on any medication that we should know about etc.
If you are over 35 and have not exercised for more than 2 years OR you have a history of heart problems/disease in your family, please consult your doctor before embarking on a training program.
Medical Background & Injury History
For which discipline/s do you require coaching?
General Health & Fitness
Mountain Biking - XCO (Olympic Cross Country)
Mountain Biking - XCM (Marathons/Enduro)
Mountain Biking - DHI (Downhill)
Road Racing - General
Road Racing - Time Trial
Road Racing - Tours
Super Masters (50-60yo)
Grand Masters (60+)
Do you have a MTBA Licence?
Do you have a CA Licence?
Number of years exercising?
Number of years cycling?
Number of years racing?
Please describe your training background including any previous training programs and coaching.
Please describe your STRENGTHS both physical and psychological when it comes to training and racing.
Please describe your WEAKNESSES both physical and psychological when it comes to training and racing.
Short term goals (up to 3 months)
Medium term goals (up to 12 months)
Long term goals (3-5 years)
Target goal (one event you wish to target within the next 12 months)
What do you hope to achieve from your training program?
Please enter here your available time to train in hours/minutes including strength training (gym) if applicable e.g. 1hr30mins or leave blank if unavailable.
Please describe a typical weeks training including what type if training e.g. road or mountain bike, how long was your training, how hard was your training and any other characteristics e.g. group rides, bunch rides, stretching, strength training, racing etc.
When planning your training, please describe your other commitments so that we can ensure you have a healthy balance of homelife, work and training.
Total number of hours available per week to train
List here ALL likely races in your schedule for the next 12 months and indicate which races you would like to do better in than others.
Please describe your best results prior to this program
Do you have a heart rate monitor?
If you have a heart rate monitor, what is the brand/model?
Do you have a wind/fluid trainer or rollers?
Please describe your current suite of bikes (brand/model etc) and who performed the bike set-up etc.
Bikes and set-ups
Do you own or have access to any gym equipment?
Own gym equipment
Member of a gym
Do you have a power meter?
How did you hear about PCS
Google Internet Search
Saw PCS at a race
If other, please describe
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Purpose of Assessment
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Contact with Coach
Thank you for submitting your coaching assessment form to Progressive Coaching Systems. We will be in contact with you shortly. If you have any questions, please do not hesitate to contact us at email@example.com.
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