Full Name *

Phone *

Email *

Last time you were part of a fitness & health routine? *

Reason for stopping health & fitness routine? *

Have you been active within the past 6 months? *

Have you invested in a coach or a coaching program in the past? *

Yes

No

If yes; what was your experience?

When (if ever) was the last time you were in the shape you wanted to be in? *

How did you feel then versus now? *

Are you trying to get in shape for an event? (holiday, wedding, reunion, marathon, though mudder, competition, etc.) *

Occupation? *

Is your occupation sedentary (spending much time seated; somewhat inactive) *

Yes

No

On a scale of 1 to 10, how serious are you about investing in your health & fitness? (1 meaning not serious at all and 10 meaning the most serious possible)? *

What monthly program price are you comfortable committing to?

$0-299 per month

$300-999 per month

$1000+ per month

What do you hope to get out of this call? *