Gettin' to know YOU!
Please answer the following questions to help me learn a little more about you and how I can help you reach your fitness and nutrition goals.
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Name (first, last)
What is the best way to reach you?
What is the best time of day to reach you? *
What is your address?
What is your date of birth?
How did you hear about us?
What types of services are you interested in?
Group fitness classes in our studio at 577 Granby Road South Hadley
Virtual Fitness Classes-workout online with us
1-1 Coaching - Personal Fitness
Nutrition - Weight Management - Meal Planning
Accountability - Support
All of the above
Do you have any physical limitations or prior injuries that you think I should know about?
Are you currently exercising or following an exercise program? If so please describe: If no when was the last time you exercised?
Is there a type of workout you prefer or you would like to try?
Dance Fitness - Zumba
Yoga - Stretching Balance - Core
Strength Training - Using weights
Barre - Ballet - Pilates - Low Impact
Chair Classes - senior fitness - beginners
Pound - Drumming Workout
Circuit Training - Hiit
Cardio Kick Boxing
Nutrition Support Group
Step - using a platform to music
Country Beat Fitness
Are you currently following a nutrition program or have you followed a nutrition program in the past? If so please describe and share your experience, what did you like and / or dislike? *
Are you on social media? If so what platform do you have? *
We like to shout out to our clients and students using our social media platforms, please check below so that we can respect your wishes.
Yes you can tag me on social media
Yes you can share pictures that I am in on social media
No do not tag me on social media
No do not share my pictures on social media
Yes you can tag me on social media in your private group only
Yes you can share pictures of me on social media in your private group only
Please ask me first
Check any of the following that apply to you.
Diabetes (Type 1)
Diabetes (Type 2)
High Blood Pressure
On a scale of 1-10 how ready are you to make changes in your life, get amazing results, feel amazing, and enjoy incredible community while you do it?
not very motivated
very motivated and ready
Please share any additional information you would like me to know
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