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Borzoni Fitness Inquiry
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Email
*
Your email
Please select your current client status
*
New Client
Returning Client
Current Client
First Name, Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Do you currently have any injuries, past surgeries or general pain? If so please explain.
*
Your answer
On a normal day do you experience any discomfort in the following locations? (Click all that apply)
*
Neck
Shoulders
LPHC (Lower Back or Hips)
Knees
Ankles
None
Required
While exercising do you experience any discomfort in the following locations (Click all that apply)
*
Neck
Shoulders
LPHC (Lower Back or Hips)
Knees
Ankles
None
Required
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