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1
Full Name
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First Name
Last Name
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2
How did you hear about us?
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3
Phone Number
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Area Code
Phone Number
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4
Do you currently have a gym membership?
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Yes
No, but I’m getting one
Prefer to workout at home
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5
What kind of training are you most interested in?
Select all that apply
Individual Personal Training
Small Group Training
Large Group Training
Virtual Training
Both In Person and Virtually
Other
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6
What does your current fitness routine consist of?
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(Days of week, program structure)
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7
Do you have a specific diet?
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If yes please give details (Macros/cals, meals, allergies,etc)
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8
In a year from now, what's your dream body look like?
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(please be specific, such as weight, body fat percentage, etc)
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9
How much progress have you made in the last month?
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(please be specific, such as weight, body fat percentage, etc)
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10
What have been your biggest roadblocks slowing you down from attaining your dream body?
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11
How much time per week are you willing towards reaching your goals?
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As Much As Needed
A Few Hours Here & There
I Have to Squeeze It In
Other
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12
What is your current motivation level on a scale of 1 to 10 to achieve your fitness goals? 1 being 'i could care less about my health so whatever' and 10 being 'I'm ready to be all in all of the time, Navy Seal style'
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1
2
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4
5
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8
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10
1
2
3
4
5
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7
8
9
10
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13
If you could buy your dream body, what would you be willing to invest?
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I would give anything for my dream body. Money isn't a concern
It would be nice but my health is not my top concern. Under $400
I know what I am doing. I am happy with what I see in the mirror. Under $100
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14
E-mail
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15
Any Additional Details You Wish To Share:
0/300
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