Fuse45 Membership Inquiry Form
Please take this Wellness Questionnaire (two minutes long, tops) and help us learn more about you so that we may customize your ideal membership!
First & Last Name
Are you interested in winning a month free at Fuse?
How did you hear about us?
From a friend
In the neighborhood
I used to be a member
Look back over your life and please describe the best you’ve ever felt... What were you doing then for fitness?
What are your specific health, wellness, and lifestyle goals?
How long do you realistically think it will take to achieve the goals you have in your mind?
Historically, what has triggered you to stop your efforts to reach your goals? (this helps us to prevent the same trigger in the future)
Everyone has something that has the potential to derail their efforts. What obstacles do you foresee standing in your way?
How often would you like to come to Fuse45 to work on your goals?
1 day per week
2 days per week
3-5 days per week
As much as possible
Only 1-2 times per month or less
When it comes to working out, are you a(n)
Mid Morning Flexer
Squeeze It In During Lunch Type
Which location(s) is/are the easiest for you to get to? *
Do you have aches or pains in any parts of your body? Any Injuries that you're working to heal in your classes with us?
Would you be interested in learning more about nutrition services if we offered them?
Just one last question, if you can imagine what your life will look like when you achieve your aforementioned goals, how will you feel? How will your life change? What will you do?
Anything else we should know?
When's the best time for us to contact you if you win free month or to discuss fitness goals?
How should we contact you?
Any of the above
Send me a copy of my responses.
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