What are some of the goals you have in mind for your fitness journey? *

Weight loss

Muscle gain

Body composition (e.g., decreased body fat percentage, increased lean muscle mass)

Injury prevention and rehabilitation

Flexibility and mobility

Balance and coordination

Posture improvement

Stress reduction

Improve self-confidence and self-esteem

Overall health and wellness

Cardiovascular endurance

Does your occupation require extended periods of sitting? *

Yes

No

Does your occupation require repetitive movements? *

Yes

No

Does your occupation require heavy lifting? *

Yes

No

Does your occupation cause you mental stress? *

Yes

No

Do you partake in any recreational physical activities (golf, skiing, etc.)? *

Yes

No

Do you have any additional hobbies (reading, video games, etc.)? *

Yes

No

Have you ever had an injury to your ankles, knees, back, or shoulders? *

Yes

No

Have you ever had any surgeries? *

Yes

No

Has your doctor ever said that you have a heart condition or high blood pressure? *

Yes

No

Do you feel pain in your chest at rest, during your daily activities of living, or when you do physical activity? *

Yes

No

Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? *

Please answer no if your dizziness was associated with over-breathing (including during vigorous exercise).

Yes

No

Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)? *

Yes

No

Are you currently taking prescribed medications for a chronic medical condition? *

Yes

No

Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? *

Please answer no if you had a problem in the past, but it does not limit your current ability to be physically active.

Yes

No

Has your doctor ever said that you should only do medically supervised physical activity? *

Yes

No

Are you interested in having a free consultation? *

Yes

No

What days are you typically available to work out? *

Monday

Tuesday

Wednesday

Thursday

Friday

Are mornings or afternoons typically available to work out? *

Mornings

Afternoons

Mixed/Flexible

Name *

First Name

Last Name

Phone Number *

We will use the phone number you provide to contact you regarding your interest in our personal training services. This may include follow-up calls or text messages to discuss your fitness goals and schedule consultations or training sessions. Your phone number will only be used for matters related to our personal training services and will not be shared with third parties. If you prefer not to receive phone calls or text messages from us, please let us know and we will contact you through other channels.

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What is your monthly budget for personal training services? *

$295 per month, 1 session per week, 1 hour per session

$589 per month, 2 sessions per week, 1 hour per session

$883 per month, 3 sessions per week, 1 hour per session