Profusion Gym Client Questionnaire Form
Your wellness journey starts NOW!
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your occupation?
What are your fitness goals?
Have you had a personal trainer before?
Are you active or sedentary?
Are you interested in personal training or semi-private group training?
Are you interested in training with your Profusion Wellness Coach two days per week or three days per week?
What days and times would you like to train each week (choose up to 3 or 4 days)? Available days Monday-Friday with mornings, afternoon, and evenings time slots open.
What services are you interested in a nutritional program?
Please list any injures and/or medications
Preferred Trainer
Please Select
Justyce
Jaida
Kristian
Submit
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