Longevita Private Session Questionnaire
Please take this quick Questionnaire to help us learn how we can help define your wellness goals!
Sign in to Google to save your progress. Learn more
Email *
What is your first and last name? *
How long have you been a client of ours at Longevita? *
What private session(s) are you interested in trying? *
Required
Have you ever tried a Pilates reformer class before?
Clear selection
Look back over your life and please describe the best you’ve ever felt... What were you doing then and who were you doing it with? *
What are your specific health, wellness, and lifestyle goals? *
What are you doing right now to achieve these goals? *
How long do you realistically think it will take to achieve the goals you have in your mind? *
Do you have aches or pains in any parts of your body? Any Injuries that you're working to heal in your classes with us? Any neurological conditions such as MS or Parkinson's Disease? *
How do you feel that private lessons may help you attain your wellness goals? *
Historically, what has triggered you to stop your efforts to reach your goals? (This helps us to prevent the same trigger in the future.)
Everyone has something that has the potential to derail their efforts. What obstacles do you foresee standing in your way? *
Required
Anything else we should know?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Longevita Pilates & Yoga. Report Abuse
Google Forms