First and Last Name

Phone Number

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?

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 inBalance to work on your wellness goals?

Are you a(n):

Which location(s) is/are the easiest for you to get to?

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?

What is the best way for us to get in touch with you?

When is the best time for us to get in touch with you?

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?

We'd love to get you started with one of our intro offers! Copy and paste one of the links below based on your preferred location and purchase one of our intro offers!