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WHAT'S HOLDING YOU BACK?

Your wellness journey awaits! Before we get started we’d love to quickly learn more about your intentions and goals so we can assist in successfully getting you there.

Initial Questionnaire

Name

Email

What's your wellness goal? (select one)

Lose Weight

Gain Weight

Maintain Weight

Increase Endurance / Cardiovascular Health

Build Muscle Strength

What's your fitness level? (select one)

Beginner

Intermediate

Advanced

What is your typical workout? (select one)

Body Weight

Weight Lifting

Cardio (treadmill, elliptical, bicycling, etc.)

Other

Not currently working out

What is your typical workout?

What are you struggling with the most? (select all that apply)

Nutrition

Motivation

Consistency

Workouts

Keeping Weight Off

Do any of these sound like you? (select all that apply)

I’m too tired.

I don’t have time.

I don’t like working out.

I’m too out of shape.

I don’t have a gym membership.

How did you find out about us?

Google

Friends and Family

Social Media

Magazine

At an Event

Other

How did you find out about us?

Best time to contact (select all that apply)

Morning

Afternoon

Evening

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