Fitness Challenge Questionnaire
These responses will help me serve you better. Rest assured that your information will never be shared and only serves to help me get to know your needs better so we can start you on a path to achieving your health and fitness goals. (No Coaches Please)
Sign in to Google to save your progress. Learn more
Have you ever felt like this?
Full Name *
Best Email Address
Best Number to Reach You
Best Time to Call *
Time
:
What time zone are you in? *
Facebook Username *
Do you have any previous or current military associations? *
What do you want to achieve? *
(check all that apply)
Required
When was the last time you would say you were in shape? *
Which is harder for you, eating right or working out consistently? *
If you are trying to lose weight how much would you like to lose? *
Did you play sports in High School, College? *
Do you have any medical concerns about working out? *
What Equipment Do You Have At Home? *
Would You Commit to spending 5 Minutes a Day Posting in a Private Facebook Support Group? *
How much time are you willing to commit per day to achieve your fitness goals *
How many days a week are you willing to workout? *
Are you vegetarian or have any special dietary needs ? *
(check all that apply)
Required
Have you ever considered or done a Nutritional Cleanse? Please share your experiences. *
Have you ever used a daily meal replacement shake to loose weight/ improve your health? *
In your opinion what is your worst "Problem Area"? *
Would you classify yourself more as a cardio junky or barbell kind of person? *
What would it be worth to you to have excellent health and the body of your dreams? *
( check one)
Do You Already Have a Team Beachbody Account? *
Would you be interested in learning how to create an income with your results? *
Would you be interested in hearing about how to get a 25% discount on all your future Beachbody purchases? *
On a scale from 1 to 10, 1 being Not Interested and 10 being Ready to Go,                                                    How do you feel about starting an at home fitness program? *
Not Interest
Ready To Go
Please check this box if you would not like for me to contact you.
Please check this box if you don't want to recieve my informative free periodic newsletter detailing my tips and tricks for living a fit and fruitful life.
What questions do you have for me? After all it's only fair that you get to ask me some too!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms