First name
Last name
Email address
Daytime or work
phone
Evening or home
phone
Best time to call
Are you currently participating in an exercise program?
Yes
No
What types of exercise are you currently participating in?
Check all that apply.
Cardiovascular (walking, jogging, running, biking, stairmaster,
etc.)
Weight Training with machines or free weights
Sports--please specify
Why are you looking for a personal fitness trainer? Please check
all that apply below, or use the box to enter any other reasons.
Fat or Weight Loss
Muscle Gain
Bored with workouts
Want to learn more about fitness and/or nutrition
Recommended by Physician, Physical Therapist, or other healthcare
professional.
Sports-specific training
Other Training Reasons:
Check which area of Houston you live in.
Inside Loop 610
Outside 610-West
Outside 610-East
Outside 610-North
Outside 610-South
Check which area of Houston you work in.
Downtown Houston
Galleria
Medical Center
Greenway Plaza
Greenspoint
Clear Lake Nasa
Do you currently have access to a gym facility or have an active
membership with a health club?
Yes
No
If yes, check the health club below or list it in the "other"
box
Bally Total Fitness
24 Hour Fitness
YMCA
Other:
Please list three of the most convenient times for you to train
in order of preference. If your chosen time slots are not open at
this time, we will add you to our new client waiting list and call
you when we have an opening.
am
pm
What is the best time to meet for a one-hour consultation?
Morning
Lunch
Evening
Weekend
Thank you! You will be contacted within 48 hours from the time
we receive this questionnaire.
Click "Send!" to send us the form.