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Bike Fitting Questionnaire
A — Profile & Training
First and last name
*
Date of birth
*
Occupation
*
How did you hear about this service?
*
A
Recommendation / word of mouth
B
Instagram @louisp_physio
C
Doctena
D
Firm's website
E
Other
Reason for the consultation
*
A
Pain / Injury
B
Discomfort while cycling
C
Performance Optimization
D
Prevention
E
New bike or equipment
F
Other
Describe your typical training week (sports you do, number of workouts, distance in kilometers)
*
Sports history: other sports played, previous fittings, skill level (recreational / competitive)
*
Season schedule and personal goals
*
B — Your equipment
Brand, model, and year of the bicycle
*
Frame size
*
Number of kilometers per year (approximate)
*
How many years have you been cycling?
*
Your priorities for this session
*
Comfort
Performance
Prevention
Do you agree to have your bike photographed during the session? ?
*
A
Oui
B
Non
C — Health & Medical History
Musculoskeletal history (check all that apply)
*
Fracture(s) or stress fracture
Surgery(ies)
Osteoarthritis
Arthritis
Muscle or tendon injuries
Osteoporosis / Osteopenia
Back or neck problems
No history
Other
Please specify the location and approximate date for each item you have checked
*
Current medical treatments (medications, supplements, injections, etc.)
*
Have you ever had a posture assessment or a bike fitting?
*
A
Oui
B
Non
If so, please provide details (date, practitioner, main findings)
*
D — Dimensions & Measurements
Height (cm)
*
Weight (kg)
*
Dominant side (lead foot)
*
A
Right
B
Left
Known asymmetries (leg length discrepancy, scoliosis, other...)
*
Current cycling shoes (brand + model)
*
Current shims (brand + type)
*
Any comments or specific expectations🚲
*
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