Goal Setting Fitness Assessment
Full Name
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Cell Phone
*
Email
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Have you worked out with a personal trainer before?
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Yes
No
What are you looking to accomplish?
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What qualities are you looking for in a fitness program?
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Sustainable weight loss and toning
More energy and vitality
Support and guidance from a qualified, competent fitness coach
Support from a group of like-minded folks helping each other
Easy-to-follow meal plan that allows me to enjoy my favorite foods
People noticing my results
Fit in clothes better
Increased confidence and self esteem
Break out of current plateau
Learn healthier lifestyle habits
Be a better role model for my child(ren)
On a scale from 1 to 10- How committed are you to reaching your goal?
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How much time can you dedicate to training based on your work/social schedule?
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Can you invest $49-$147/week?
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Yes
No
Are you the Main Decision Maker or Will you need you're spouses support?
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Yes
No! I need my spouse's support
SUBMIT
500 E. Lodi Ave Ste B2
Lodi, Ca 95240
