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Challenge By Choice
Female Athlete In-take Form
Name
*
First Name
Last Name
Email
*
Date
MM
DD
YYYY
Sport
Age
Current Menstrual Cycle
Getting a regular period
Pre-Menopause
Menopause
PeriMenopause
Do not get a regular period
Are your periods Regular?
Yes
No
If Yes: How long is your cycle (ex - 28 days or other)?
If Yes: How many days does your period last for?
What was the START date of your last period?
MM
DD
YYYY
What was the date of your last ovulation?
MM
DD
YYYY
Are you taking an oral contraceptive (ie - the pill)?
Yes
No
If Yes: Which one?
If Yes: For what reason?
(ie - prevent pregnancy, hormone regulation etc.)
Are you using an ICP (ex - IUD)?
Yes
No
If Yes: Which one?
If Yes: For what reason?
(ie - prevent pregnancy, hormone regulation etc.)
Are you currently tracking your periods?
Yes
No
If No: You may want to: Here is Free App to consider as it was designed for athletic females:
FITRWOMAN
Upon sign up, please connect your account to Jen’s so that your training can work WITH and NOT AGAINST your unique, individual female cycle. "Use code NJEJS to link to Jen"
Anything else that your coach should know related to your female health?
Should anything change with your health, be sure to notify Coach Jen immediately!
Thank you!