Getting Started

Name
Address 1
Address 2
City
State
ZIP Code
Email Address
Top 3 Health, Wellness and Fitness Goals:
1. 1.
2. 2.
3. 3.
What would change in your life if you accomplished these 3 goals?
What other programs have you tried?
Do you exercise regularly now?
1. Yes
2. No
How frequently?
What kind of exercise do you primary do (cardio, weight training, swimming, etc.)?
What is the duration of a typical exercise session for you?
Are you a member of a fitness club?
What kind of equipment does the club provide:
1. Free weights
2. Cardio Equipment
3. Resistance Machines
4. Pool
5. Other
How much time are you willing to commit to achieving your objectives?