Customized Program
Questionnaire
Current Level of Fitness *
Great
Average
Poor
Athlete
Where would you prefer to workout? *
Home
Gym
What type of equipment would you like to use? (
check all that apply
)
Body Weight (BW)
Bands
Dumbbells (DB)
Barbells (BB)
What's your primary fitness goal over the next month? *
Lose weight/Get Lean
Strength
Muscle Mass
Conditioning
Other (Please explain in comment section below)
What is your secondary fitness goal over the next month? (If only one goal leave blank)
Lose Weight/Get Lean
Strength
Muscle Mass
Conditioning
Other (Please explain in comment section below)
How many workouts per week would you like? *
1
2
3
4
5
6
Anything that we should know about you to help us get you on the right path?
Comments:
Name & Email:
First Name *
Last Name *
Email *
Phone *
Preferred Trainer
Submit