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REGISTRATION
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Email
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Your email
Name:
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Your answer
Phone Number:
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Your answer
What are your main goals?
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weight loss
muscle gain
athletic performance
rehabilitation
medical
lifestyle
Other:
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What are the specific outcomes you want to achieve? Examples: lose 20 lbs, lose 10% bf, gain 10 lbs muscle, fit a size 3, run 1/2 marathon, bring blood pressure within normal range...
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Your answer
when are you looking to train
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mornings 6am-11:30am
mid day 11:30am-3:30pm
afternoon/evenings 3:30pm-8pm
later at night 8:00pm-12pm
Other:
On a 1-10 scale how committed are you to reaching this goal?
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1
2
3
4
5
6
7
8
9
10
What is the time frame to get to you goal?
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1-3 months
3-6 months
6-12 months
1-2 years
3+ years
Other:
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What would it mean to you if you could reach your goal?
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Your answer
What is your monthly budget?
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$100-299
$300-499
$500-999
$1000+
Other:
What are some obstacles?
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Your answer
What aspects do you feel you need help with the most?
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education (don't know what to do or how to do it)
accountability (having someone to check in with to make sure your on track)
motivation (someone to push and drive you outside your comfort zone)
Programming (prioritization of training &/or nutrition)
Other:
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preferred trainer?
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Your answer
Did someone refer you to us?
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preferred method for consultation
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in person
phone
online
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