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The Bike Shop Fit Questionnaire

Name

Age

Gender

M

F

Address

City

Zip

State

Phone

Email

Years of serious cycling

Hours of weekly cycling (current)

Have you been fit before?

Y

N

When are your ‘A’ races this year:

Past or current joint or overuse injuries?

_

_

Y

N

Which?

Are you currently seeing a Chiropractor/Physical Therapist?

If so why?

Cycling goals

Please rate your current fit:

1. Super comfortable and very fast

2. I’m comfortable, but not very fast

3. I’m uncomfortable, but very fast

4. I’m uncomfortable, and slow

What would be your ideal bike fit?

1. Super comfortable and very fast

2. Comfortable, but not very fast

3. Uncomfortable, but very fast

4. Uncomfortable, and slow