Ecole de Pole Wellness Questionnaire
Please take this Wellness Questionnaire (two minutes long, tops) and help us learn more about you so that we may customize your ideal membership!
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Email *
First and Last Name *
Phone Number *
Which location are you interested in attending?
Clear selection
How did you hear about us? *
Have you taken classes with us before? If so, please tell us about your experience. *
Why do you want to start classes with us? Why do you want to try such niche classes instead of the gym or 'normal' workout classes? *
What do you do for work and/or school? *
What are your specific health, wellness, and lifestyle goals? If you've taken classes with us before, are there specific moves or exercises that you are working on right now? *
How long have you been thinking about these goals and what are you doing right now to achieve these things? *
How long do you realistically think it will take to achieve the goals you have in your mind? *
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
What is your regular weekly schedule like? *
How often would you like to come to Ecole de Pole to work on your wellness goals? *
Who is in your current support system? Are these people in favor of you meeting your goals? *
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? *
How serious are you about meeting your goals? *
Just one last question, if you can imagine what your life will look like when you achieve your aforementioned goals, how will you feel? How will your life change? What will you do? *
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