LONDON BARRE QUESTIONNAIRE
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 and Last Name
How did you hear about us?
Around the neighborhood
From a friend
I'm a current member
Look back on your life and please describe a time when you felt at your absolute best... What were you doing then and who were you doing it with?
What are your specific health, wellness, and lifestyle goals?
What are you doing right now to achieve these 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 London Barre to work on your wellness goals?
As much as possible
Only 1-2 times per month or less
Have not decided yet
Are you a(n):
Early bird (6am)
School drop-off (9:30am- 10am)
Mid-morning enthusiast (11am)
Mid-day merger (Noon)
Early evening flexer (4:30pm-5:30pm)
Night owl (6pm-8pm)
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?
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?
A copy of your responses will be emailed to the address you provided.
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