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NEEDS ASSESSMENT
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1
Name
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First Name
Last Name
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2
E-mail
*
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example@example.com
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3
Your Age?
We have members ranging from 16 years of age up to men & women in their 60's!
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4
Are you living / working locally, where?
Will the commute work for you?
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5
Previous CrossFit Experience? When and where did you train?
Let us know your history!
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6
Please Select What Times you can Train at?
The more flexible, the better so we can offer you a membership!
Mon-Fri 5:45am
Mon-Fri 6:45am
Mon-Fri 7:45am
Mon-Fri 9:30am
Mon & Fri 12pm
Mon-Fri 4pm
Mon-Fri 5:15pm
Mon-Fri 6:15pm
Mon-Thurs 7:15pm
Saturday 8am
Saturday 9am
Saturday 10am
Other
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7
How many times a week can you train?
No probs if this is something you need to figure out but if you know, list the days and times you can commit to:
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8
Where did you hear about us? Do you know any of the CFL members?
Please tell us the name of the member you know!
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9
Does going to a gym intimidate you?
Promise we are not the scary type!
YES
NO
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10
Have you ever been coached by a professional before?
Coaching is our thang!!
YES
NO
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11
Have you ever been in a fitness class?
We are more than just a fitness class...Coached Group Training is our speciality!
YES
NO
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12
Does meeting like-minded people who are great craic interest you ?
We are a Community based training facility. People are everything. You may meet the love of your life!
YES
NO
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13
Image Field
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14
How good would you say your eating habits are? 1=Poor
Nutrition is the foundation to CrossFit and long term health & fitness...we can show you later if you want!
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2
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Very poor!
Amazing
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15
How would you rate your rest/sleep? 1 = Poor
The other foundation of mental and physical health!
1
2
3
4
5
Inconsistent: 3-6 hour range
Consistent: 8+
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16
How stressful is your job/lifestyle?
Let us help you de-stress and let off a bit of steam quite literally!
1
2
3
4
5
I am stressed!
I am chilled to the max!
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17
Image Field
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18
What experience do you have in fitness?
None required but good to know details! Tick as many boxes as possible!
None
Heaps
Some
I'm a Pro!
Fitness is my Life!
I Need Help!
Completely New To CrossFit
Little CrossFit Experience (< 3 Months)
Some CrossFit Experience (< 1 Year)
CrossFit Experienced (Consistently < 2 Years)
CrossFit is my Life! (< 3 Years Consistently)
Other
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19
Please list any sports or activities you do or have done, if any ?
Good to know info ;)
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20
What motivated you to get in touch with us and try
some Fitness now?
It doesn't matter where you are at, we will meet you exactly there!
I'm fed up of not taking action
I want to try something new
You've been highly recommended
I need a push into action
I don't know how to do this alone...
Other
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21
What would you like to achieve and is important to you?
Tick as many as you like!
Fitness Increase
Improve Nutrition
Better Energy
Weight Loss
Strength Gain
Improved Mental Health / De-stress
Skill Increase
Build Muscle
Habit Creation
Lifestyle Adjustment
Improve Performance for a Sport
To Get Strong for Life
All of the Above
Other
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22
Why do you need to be fit and healthy?
*
This field is required.
I want / need fitness in my life because ....family, kids, need support, fit for life, mentally toughen, etc
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23
Do you have a timeline to achieve your goal?
If not, is it more of a lifestyle change maybe?
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24
What is important to you?
Do our values align and can we offer what you need?
Community Feel
Caring Coaches
High Intensity Training
Competitive Elements
Support and Accountability
Motivating Staff
Club Environment
Guidance and learning
Learning about Nutrition
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25
Image Field
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26
(Turn to landscape view if on phone)
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27
We are a learning environment. We will teach you new skills every day. To develop and grow in your fitness performance, can you train with us a minimum of 2-3 times a week to build consistency, work on technique and chase those goals!?
*
This field is required.
YES
NO
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28
Remember, it takes 90 days or more to create a new lifestyle, can you commit to a minimum of 3 months training upon sign up? i.e. - will not cancel within 3 months of joining?
Yes definitely!
No I can't commit.
Maybe, I'm unsure
Call me about this.
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29
Let's get started and put a plan in place!
I would like to meet for a chat
I would like to try a session
Please Call Me About This
I'm unsure yet
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30
If not already decided, pick a date to meet or trial a session with us:
Please note we will be in touch to invite you in for a trial session as soon as possible based on your answer below.
-
Date
Day
Month
Year
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31
I understand there is a Wait List to trial a session:
We retain our members for long periods and some classes are busier than others. Based on your flexibility to train we can get you in sooner!
YES
NO
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32
Do you have any current or a history of, any injuries/restrictions or health concerns we should be aware of?
Please list any medication you are on if you wish and any injuries or health issues we should be aware of.
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33
Do you have any known Cardiac (Heart) Conditions?
Important information we need to be aware of!
I have no known cardiac conditions.
Yes, I am on medication for my heart. (Please contact us about this)
I did in the past but given the All Clear to exercise now by my doctors.
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34
If you haven't been training in recent times have you been given the all clear to exercise or train with intensity by a doctor or health professional?
Yes
No
N/A
I am postpartum and have been given the all clear to exercise
I am postpartumn and seeing a Pelvic Floor Physio
I am postpartumn and awaiting clearance
I am unsure
Other I will explain in person
Yes
No
N/A
I am postpartum and have been given the all clear to exercise
I am postpartumn and seeing a Pelvic Floor Physio
I am postpartumn and awaiting clearance
I am unsure
Other I will explain in person
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35
Are you interested in learning about Nutrition?
Yes, I understand the importance of Nutrition when it comes to Health and Fitness
Sign Me Up for a Free Intro Consult with a Nutrition Coach
I'd like to learn more about Nutrition Coaching
No, I already have help with Nutrition
I've already got a Nutrition Coach
Not Interested
Other
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36
Any Friend or Family Member Comes to Mind?
Who do you feel needs this also? Pop their name down below:
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37
Emails from CFL
We will send you occasional info emails to communicate with you where needed.
That's OK with me.
No Thanks
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