Confirmation for 8 Week Law Enforcement, Firefighter, or Military Running Plan

Thank you for requesting an 8 week plan for the Law Enforcement, Firefighter, or Military running tests.

To get started as soon as possible with your plan, we need information about you. Please fill out the questionnaire below to the best of your abilities. If you feel some questions are not applicable, do not fill them out.

But, the more information you give us the better we can put together your plan.

Typically, once you fill out this questionnaire, the turnaround time for your running plan will be about 7 days. We will send it to you via the email you provide with further instructions on how to proceed at that time.

Please bookmark this page in case you can’t fill out the questionnaire now.

We look forward to helping you achieve your goals!

Comments
This field is for validation purposes and should be left unchanged.
Introductory Stats
Name
First Last
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (Home)
Phone (Cell)
Date of Birth
Sex
- Male
- Female
Height
Weight
Body Fat Percentage (If Known)
10 Yard Dash Time
20 Yard Dash Time
20 Yard Shuttle Time
40 Yard Dash Time
Any other distances and times that might be applicable to your training program
Vertical Jump
Standing Broad Jump
How long can you hold a plank?
Bench Press Max
Squat Max
Clean Max
Deadlift Max
Single Leg Extension Max (L/R)
Single Leg Curl Max (L/R)
How far down can you touch your toes while keeping your legs straight?
How well can you do an overhead squat holding a broomstick?
Athletic Background
If you played varsity sports in high school, please list them
Please list the recognition you received for each varsity sport if any (i.e. captain, all league, team MVP)
If you played sports in college, please tell your college and the sport(s) you played
Please list the recognition you received for your collegiate sport if any (i.e. captain, all league, team MVP)
If you played sports beyond college in the professional ranks, national teams, semi-pro, overseas, etc., please list your teams and sports
Please list the recognition you received for your professional sport if any (i.e. captain, all league, team MVP)
Exercise Program
How often have you used dumbbells with your workouts?
How often do you use free weights with a bar in your workout program?
Do you know how to do the Olympic lifts (at least a clean, snatch, and variations)?
If you are currently working out, please list the exercises you are doing (don't list cardio, that is later)
Please tell me any follow up details you need to with this workout (training split, frequency, intensity, sets/reps, etc.)
If you are doing cardio with your workout, please explain what you are doing for cardio
If you are not working out, please tell me how long it has been since you have been on a consistent workout routine
If you haven't been working out, what have been the biggest obstacles keeping you from that and why will it be different this time?
Goals
What are your immediate short term goals that you want to accomplish in your sport (next 3 months or for your upcoming season)? - Just in general, not specific to my service.
What would be your long term goals for your sport you want to accomplish (a year out)? - Just in general not specific to my service.
What are your immediate goals with me and my service? What can I help you with that will help you accomplish your goals faster?
Besides your sport goals are there any health related goals we need to consider that you didn't previously mention (build muscle/size, lose weight/fat)?
Have you tried to accomplish your goals before and not succeeded? If so, why?
What would be your biggest obstacle to overcome to accomplish your goals?
Besides me dropping the ball and giving you a crappy program (which won't happen), are there any other excuses you can think of that would keep you from success for this program? I want to eliminate all excuses.
How will my online coaching help you accomplish your goals?
Have you ever used an online service like this before? If yes, please list what it was, success that you did or did not accomplish, and why you aren't using them again?
Have you ever hired a personal trainer or athletic training company to train you offline and get you to accomplish your goals? If yes, critique how beneficial it was or wasn't.
Why are you choosing this particular time to try my service and get you to where you want to be?
Why did you ultimately decide that I was the best option to help you accomplish your goals?
How did you hear about us (be specific)?
If referred: please tell us by whom, so we can thank them. Or list the website, fitness pro, etc.
Medical Issues
Please list any illnesses, aches, pains, medical conditions, that could manifest during your training. Please describe in detail
Are you on any medications? If so, please list
Do you have any allergies or medications? If so, please list
Once more, any aches, strains, anything we need to know that is bothering you currently?
Any other medical issues you need to tell us
Nutrition
On a scale of 1 (poor) to 5 (great), how do you rate your eating habits?
Please choose your feeling on your eating habit
I get at least 5 servings (combine) of fruits and vegetables
I take a quality multi-vitamin daily
I struggle with food cravings in the middle of the day
What is the one food you eat all the time, know is not good for you, but you can't control yourself? Why?
Besides a multivitamin, have you ever taken any supplements? If yes, list them and explain why. If no, explain why not.
Have you ever taken a fad diet (Zone, South Beach, etc.)? If so, which one and what happened?
How do you view eating? Are you emotionally driven? Does it mean anything to you? Etc.
Your current eating plan? Is it a plan at all? How do you decide what you are eating on a daily basis?
Please list down, in an orderly fashion, what you have eaten and drank in the last 2 or 3 days.
Exercise Equipment
Do you have access to dumbbells and benches or stability balls?
Do you have access to bumper plates and/or a lifting platform?
Do you have access to free weights and bars or Olympic bars?
Do you have access to kettlebells?
Do you have access to hammer strength equipment?
Do you have access to any other exercise machines such as cybex, nautilus, etc.?
Do you have access to medicine balls? If so, please specify the weights:
Do you have access to stability balls?
Do you have access to a TRX suspension unit?
Do you have access to a track or running trail to do potential long runs?
Do you have access to a treadmill that can go up to 10+ mph and/or incline?
Do you have a location to run sprints up to 40 yards?
Do you have a space 40'x40' to do agility, plyometric work?
In the program, I have some drills where you can use extra equipment. If you don't already have access to it. What would be your budget to purchase extra equipment to improve your speed/power?
Some drills utilize a partner. Do you have someone who could help you out?
Personality (Who You Are and What Makes You Tick)
If you played organized sports before, did you ever quit in the middle of the season? Why?
What do you like to do for fun?
Favorite Music?
Do you have any close family or friends that knows what you are going to be doing? Who are they? What type of support will you expect from them?
What are your favorite hobbies?
Do you have any pets?
Have you ever committed to a project and not see it through to the end? If yes, why?
Why would I want to work with you?
Favorite books or magazines
Favorite sport and team(s)
Favorite athlete and why?
Favorite TV Shows
Favorite Movies
What do I need to know about you to make this coaching as successful as possible? What do I need to do?
Anything else I need to know about you
- When I see the results I'm looking for, I will definitely provide an awesome testimonial and a picture to use at your discretion.
- I will have a positive attitude and have fun. I will not use words such as "No" or "Can't", but instead use words such as "I will try my best." I will allow the specialists to encourage and push me to a fitness level that I never imagined.
By submitting this form, you indicate that you agree to the Terms of Use Agreement and have read and understand the Privacy Policy and Medical Disclaimer of the Fitness Planning Consultants, Inc. Fitness Planning Consultants, Inc. shall not be liable to the signee, nor any other person, for any claims or cause of action whatsoever arising out of or connected with the services of Fitness Planning Consultants, Inc.; and that I hereby release and discharge Fitness Planning Consultants, Inc. from any such claims or actions.