VMax Enquiry Form

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VMax Enquiry Form

Hey.
Thank you For Showing Interest in Our Guaranteed Transformation Program.
Please Fill out this Simple Form so that We will have an Understanding of How We can Assist you in your Fitness Journey.

First Name *

Last Name *

Name Title *

Mr.

Miss.

Mrs.

Dr.

Other:

Email Address *

Your Mobile Number *

Please enter your mobile number with country code i.e., India - (+91 9XXXX XXXXX)

Your WhatsApp Number *

Please ignore if your what's app number is same as your mobile number

Where did you first hear about VMax? *

Social Media Handle Name *

Please provide your Facebook and Instagram ID @

Location *

Please enter your CITY, STATE and COUNTRY.

Gender *

Male

Female

Age *

Date of Birth *

YYYY

Preferred Language? (Mother tongue) *

Height *

Weight( Kg) *

Profession *

Working Professional

Home Maker

Business Owner

Doctor

Student

Other:

More details about your Profession *

If you are a Doctor, please specify your Specialty (Dentist/Cardiologist). If you are into Business, please specify your nature of Business. If You are an Engineer, please specify your specialty (Software/Mechanical etc.)

How Active is your Lifestyle ? *

Sedentary (work a desk job) OR No Exercise

Lightly Active OR Exercise 1-3 days / week)

Moderately Active OR Exercise 3-5 days / week

Very Active OR Exercise 6-7 days / week

Work Hours *

Eg : 9am to 5pm - Please specify AM or PM.

What is your body type? *

Ectomorph (Lean and long, with difficulty building muscle)

Mesomorph (Muscular and well-built, with a high metabolism and responsive muscle cells.)

Endomorph (Wide body, often pear-shaped (For Women), with a high tendency to store body fat.)

What is your Most Primary Fitness Goal from the list below ? *

(Choose your primary Goal.)

Lose Weight and Look Lean,

Lose Weight and being able to Perform my everyday activity with more Energy and more Productivity

Comfortably climb a 5 story stairway, without losing Breath nor Struggling much,

Increase Overall Strength and have more Muscle,

Put on Healthy Weight (i.e) put on Lean Muscle and Gain Overall Body Strength,

Improve Endurance, (Endurance is the Ability to perform an action in a continuous pace). (Example:Comfortably run a Mini Marathon of 3-6 Kms),

(Men) Aesthetic and Muscular body, with Visible Six pack Ab, like a Male Model,

(Women) Aesthetic and Toned body, like a Female Model,

Other:

Required

What is your Most Challenging Pain Point which is stopping you from achieving your fitness goals? *

No Time to Exercise

Lack of Proper Knowledge about Planned and Balanced Nutrition

No Time to prepare Healthy meals at home

Healthy food is not Tasty

No Motivation

Physical Injuries

Fitness is Expensive and Inaccessible

Fitness is not Fun

Looking for an Easy, Time efficient and Long Term Sustainable solution for my Fitness goals

Other:

Required

Any Existing Body Pain? *

Knee pain

Shoulder pain

Neck pain

Back pain

Nill

Other:

Required

Any existing Health Issues ? *

Diabetes

Thyroid

Cholesterol

PCOS (For Women)

Cardiovascular

Nil

Other:

Required

On a scale of 1-10, how committed are you to achieve your Fitness Goals ? *

Worst

Best

If your answer to the Commitment Level Question (the previous question), was below 8. Please specific why do you think you lack the Commitment Level to achieve your Health and Well-being ? If you are above 8, Just type your number(8/9/10) again.

Thank you for Filling the form Please click the Submit Button Below

Kindly Let us Know after filling the Form. Our Team will Reach out You Shortly.

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