Unlimited Sports Management's Health and Performance Form Name Prénom Nom Date of birth AgeWeight (pounds)Height (Feet)(Ex. 5'10 ) Email PhoneAddress Adresse postale Adresse ligne 2 Ville État / Province / Région ZIP / Code postal AfghanistanÅland IslandsAlbanieAlgérieSamoa américainesAndorreAngolaAnguillaAntarctiqueAntigua-et-BarbudaArgentineArménieArubaAustralieAutricheAzerbaïdjanBahamasBahreïnBangladeshLa BarbadeBelarusBelgiqueBelizeBéninBermudesBhoutanBolivieBonaire, Sint Eustatius and SabaBosnie-HerzégovineBotswanaBouvet IslandBrésilBritish Indian Ocean TerritoryBrunei DarrussalamBulgarieBurkina FasoBurundiCambodgeCamerounCanadaCap-VertÎles CaymanRépublique centrafricaineTchadChiliChineChristmas IslandCocos IslandsColombieComoresRépublique démocratique du CongoRépublique du CongoCook IslandsCosta RicaCôte d’IvoireCroatieCubaCuraçaoChypreRépublique tchèqueDanemarkDjiboutiDominiqueRépublique DominicaineÉquateurÉgypteSalvadorGuinée équatorialeÉrythréeEstonieEswatini (Swaziland)ÉthiopieFalkland IslandsÎles FéroéFidjiFinlandeFranceFrench GuianaPolynésie françaiseFrench Southern TerritoriesGabonGambieGéorgieAllemagneGhanaGibraltarGrèceGroenlandGrenadeGuadeloupeGuamGuatemalaGuernseyGuinéeGuinée-BissauGuyaneHaïtiHeard and McDonald IslandsHoly SeeHondurasHong KongHongrieIslandeIndeIndonésieIranIrakIrlandeIsle of ManIsraëlItalieJamaïqueJaponJerseyJordanieKazakhstanKenyaKiribatiKoweïtKirghizistanLao People's Democratic RepublicLettonieLibanLesothoLiberiaLibyeLiechtensteinLituanieLuxembourgMacauMacédoineMadagascarMalawiMalaisieMaldivesMaliMalteÎles MarshallMartiniqueMauritanieÎle MauriceMayotteMexiqueMicronésieMoldavieMonacoMongolieMonténégroMontserratMarocMozambiqueMyanmarNamibieNauruNépalPays-BasNew CaledoniaNouvelle-ZélandeNicaraguaNigerNigériaNiueNorfolk IslandCorée du NordÎles Mariannes du NordNorvègeOmanPakistanPalauÉtat palestinienPanamaPapouasie-Nouvelle-GuinéeParaguayPérouPhilippinesPitcairnPolognePortugalPorto RicoQatarRéunionRoumanieRussieRwandaSaint BarthélemySaint HelenaSaint-Christophe-et-NevisSainte-LucieSaint MartinSaint Pierre and MiquelonSaint-Vincent-et-les GrenadinesSamoaSaint-MarinSao Tomé et PrincipeArabie SaouditeSénégalSerbieSeychellesSierra LeoneSingapourSint MaartenSlovaquieSlovénieÎles SalomonSomalieAfrique du SudSouth GeorgiaCorée du SudSouth SudanEspagneSri LankaSoudanSurinameSvalbard and Jan Mayen IslandsSuèdeSuisseSyrieTaïwanTadjikistanTanzanieThaïlandeTimor-LesteTogoTokelauTongaTrinité et TobagoTunisieTurquieTurkménistanTurks and Caicos IslandsTuvaluOugandaUkraineÉmirats arabes unisRoyaume-UniÉtats-UnisUruguayUS Minor Outlying IslandsOuzbékistanVanuatuVenezuelaVietnamÎles Vierges britanniquesÎles Vierges américainesWallis and FutunaWestern SaharaYémenZambieZimbabwe Pays What are your goals in hockey? (Short and long-term)What would you like to improve as an athlete?( Ex: Strength, muscle mass, power, speed, recovery, energy...)Part 1 : Digestive system and immune systemDigestive system: Click on the signs & symptoms you have or you have had in the last 30 days. Excessive yawning Gall bladder stone Stomach cramp Stomach burn Diarrhea Constitpation/ Alternance of diarrhea and constipation Gaz, bloating Dont eat a lot Still feel hungry after eating Immune system: Do you often get a cold or the flu during a hockey season? If so, how frequently? (approximately)Immune system: Have you ever taken antibiotics? If so, for how long and for how many times? (approximately)Part 2: Musculoskeletal system and training recoveryMusculoskeletal system and training recovery: Click on the signs & symptoms you have or you have had in the last 30 days. Muscle cramps Joints' stiffness Difficulty to gain muscle mass Difficulty to focus Memory loss Slow recovery from training ( Ex. Long delayed onset muscle soreness (DOMS) from strength training) Insufficiant work capacity (Get tired easily with metabolic work surch as aerobic/cardio work) Lack of endurance strength (Get tired easily with muscular work) Lack of strength Lack of power Slow recovery from a physical injury (Takes more time than it should to recover) Part 3: Sleep and energySleep Difficult to fall asleep Wake up at night (one to several times) Still tired even after a full night of sleep I often dream. I often have nightmares. I have muscle cramps at night. Energy: Out of 10, how's your level of energy in the morning?Please enter a number from 1 to 10.1: Extremely tired 10: Very energeticEnergy: Out of 10, how's your level of energy at noon?1: Extremely tired 10: Very energeticEnergy: Out of 10, how's your energy at 3:00 o'clock PM?1: Extremely tired 10: Very energeticEnergy: Out of 10, how's your energy at 8:00 o'clock PM?1: Extremely tired 10: Very energeticPart 3: Supplements and food planDo you take supplements?YesNoIf so, what do you take? (company name, product, posology)Ex. Ortho Molecular Products, Mitocore (multi-vitamins), 2X AM Δ