Virtual Group Coaching & Exercise Interest Form
The Wholistic Vitality Fusion Group Program
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Why are you interested in group coaching & exercise?
On a scale of 1-10, 1 being the lowest and 10 the highest, what is your level of commitment to your health and wellness?
What ailments do you suffer from or what medical conditions should I know about? (i.e. diabetes, weight loss surgery, constipation, obesity, etc.)
What are your top 3 health and wellness goals? (i.e. Lose 10 pounds; meal prepping; exercising, etc.)
Submit
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