Potential Lead Questionnaire

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Welcome

Hi there, please fill out and submit this form.

15Questions

1
When do you need this service?
Weekday Mornings
Weekday Evenings
Weekday Afternoons
Saturday
Sunday
2
Who's getting trained?
Individual
Group up to 6
Pair or Couple
Group up to 4
3
How often do you exercise now?
Rarely
3-4 times per week
1-2 times per week
Almost everyday
4
What's your main fitness goal?
Lose Weight
Build Muscle
Get Toned
Gain Flexibility
Build Stamina
Other
5
Are you getting fit for something specific?
Not training for specific event
Vacation
Athletic event or competition
Wedding
Other
6
Do you have any medical concerns or injuries?
Back problems
Asthma
Joint pain
Pregnancy
Other injuries/medical conditions
7
How old is the client?
Younger than 18
41-50
18-22
51-60
23-30
61-70
31-40
71 or older
8
Do you prefer a trainer of a certain gender?
No gender preference
Male trainer preferred
Female trainer preferred
9
Where do you want to train?
Location recommended by trainer
Public outdoor location
Trainer's gym
My home or apt gym
Remote/Online training
10
How often do you want to train?
Once a week
2-3 times a week
4-7 times a week
11
Enter zip code where you need personal trainer
12
Enter email address to send trainer response
13
Please enter your full name
14
Do you prefer "Call" or "Text"?
15
Phone NumberPlease provide a contact number
Please enter a valid phone number.
Should be Empty:

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