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Black Bear Fitness, LLC: Client Interest Questionnaire
Please complete the following to help me to get to know you!
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Email
*
Your email
Please enter your first and last name
*
Your answer
What is your current age?
*
Your answer
What is your
gender?
*
Male
Female
Other
Which program are you interested in?
*
Level 1: Playful Panda--> Macros only
Level 1: Playful Panda--> Workout Plan only
Level 1: Playful Panda--> Both macros and workout plan
Level 2: Grizzly Grit--> Macros and/or personal training monthly plan
Level 2: Grizzly Grit--> Macros and/or personal training 3 month plan
Level 2: Grizzly Grit--> Macros and/or personal training 6 month plan
Level 3: Polar Power--> Both macros and personal training monthly plan
Level 3: Polar Power--> Both macros and personal training 3 month plan
Level 3: Polar Power--> Both macros and personal training 6 month plan
Why are you interested in my service(s) and how did you find me? Did a current client refer you?
Your answer
How would you describe your current eating/nutritional habits?
Your answer
What is your current fitness program and/or training/workout/sports history?
Your answer
What areas of your personal fitness and/or nutrition would you like to improve? Do you have any goals?
Your answer
Which Hogwarts house do you belong in? I'm in Ravenclaw ;-)
Gryffindor
Hufflepuff
Ravenclaw
Slytherin
Not a clue
Clear selection
Is it ok for me to use the e-mail address you provided to contact you concerning an initial live meeting?
*
Yes
No
If you answered "No" to the above, how would you like me to contact you?
*
Your answer
Are you ready to make a commitment to yourself and your overall well being?
LET'S GO!
I'm ready, but nervous
I think I'm ready, I just need a lot of guidance
I'm not sure
Clear selection
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