Start Your Results in Advance Intro Program
DFW's #1 Private Training Club for Busy Adults
How did you hear about us
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Instagram
Facebook
Friend/Family
Recent/Current Client
TikTok
Door Flyer
Radio/Media
Other...
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
What type of training are you inquiring about?
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In-Person Training
Online Training
Small-Group Training
What city are you a resident of?
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Gender
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Male
Female
Other
Birthday
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-
Month
-
Day
Year
Date
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Subjective Information
Tell us about yourself...
Height (ft'in)
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Weight (lbs)
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Age
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Have you ever been injured?
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Yes
No
Areas of pain/injury? (if applicable)
*
Select your Coach
Preferred Coach
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Please Select
Baylore Walker
Tiffany Riley
Markeith Day
Select your Coach
What is your activity level at work?
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Sitting down most of the time
Sitting down and moving around
Standing for long periods
Standing and moving around
Moving around a lot
Currently not working
What is your activity level outside of work?
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Exercise 0-1 per week
Exercise 1-2 per week
Exercise 2-3 per week
Exercise 3-4 per week
Exercise 4+ per week
What do your workouts usually consist of?
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Cardio mostly
Cardio & Strength training
Strength training mostly
High Intensity Interval training
Sports Performance training
Pre/Rehabilitation
Not working out right now
Other
What tome frame do you prefer to have training session in?
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5 AM - 12 PM
12 PM - 4PM
4 PM - 8PM
All of the above
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Behavioral Habits
This section will help us get a better understanding of your background, and behavior habits to recognize counterproductive behaviors and coach them to discover new methods with the goal to improve your activity level, goal oriented eating habits, and make healthier decisions for yourself long term
What is your overall goal?
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How long have you been thinking about getting assistance with this goal(s)?
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Who have you been discussing your health & fitness goals with?
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How motivated are you to reach your overall health & fitness goals on a scale of 1 through 10 ( 10 being HIGHLY MOTIVATED and 1 being EXTREMELY UNMOTIVATED)
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1
2
3
4
5
6
7
8
9
10
1 is , 10 is
Select all the actions that may apply to you (please be honest!)
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LIttle to no exercise
No real diet
Eating chip/crackers
Eating sweet frequently
Drinking alcohol throughtout the week
Eating after hours
Not meal prepping regularly
Barely drinking any water
Drinking soda or juice throughout the week
Highly stressed out
Getting less than 6 hours of sleep
Not eating fruit regularly
Not eating veggies regularly
Not tracking calroies
What can you see holding you back from starting a consistent routine with a fitness professional?
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Are you willing to commit to a 3-12 month Health and Fitness program?
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Yes
No
What is your anticipated starting date for training?
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-
Month
-
Day
Year
Date
How would you prefer to consult with us?
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Please Select
In-Person
Google Meets
Who would you prefer to consult with?
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Please Select
Baylore Walker
Markeith Day
Dria Jackson
Tiffany Riley
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