Pace Fitness, Inc. - Client Intake
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What is your first and last name? *
What type of health services are you seeking? (Check all that apply) *
Required
Describe a normal work days activity level. *
What are your health and fitness goals? (non-numerical) *
What is your current relationship with your body? Describe in detail. *
What do you believe has stopped you from reaching your fitness goals in the past? *
What would your perfect personal trainer be like? *
Do you have any serious medical issues that we should know about? *
When was your last physical exam? Have you been cleared for physical activity by your family doctor? *
How did you hear about us? *
What is the best email address to use for contact? *
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