105F 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!
Email address *
First and Last name *
Your answer
Phone Number *
Your answer
How did you hear about us? *
Look back over your life and please describe the best you’ve ever felt... What were you doing then and who were you doing it with? *
Your answer
What are your specific health, wellness, and lifestyle goals? *
Your answer
What are you doing right now to achieve these goals? *
Your answer
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) *
Your answer
Everyone has something that has the potential to derail their efforts. What obstacles do you foresee standing in your way? *
Required
How often would you like to come to 105F to work on your wellness goals? *
Are you a(n): *
Required
Which location(s) is/are the easiest for you to get to? *
Required
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? *
Your answer
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? *
Your answer
Anything else we should know?
Your answer
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