Lunch Express Sign Up
Name
First Name
Last Name
Email
example@example.com
Age
Birthday
-
Month
-
Day
Year
Date
What level of fitness would you rate yourself at?
Needs Improvement
1
2
3
4
5
6
7
8
9
I workout with very few restrictions
10
1 is Needs Improvement, 10 is I workout with very few restrictions
Can you get up and down off the floor?
Yes
No
Yes but I might be slow.
Sometimes
Other
Are you currently paying for other services at Watson Wellness?
Member/ Current Client
Not currently paying for any services- " Non member"
What package would you like to start with?
5 pack
10 pack
15 pack
Other
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