inBalance 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!
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Email *
First and Last Name
Phone Number
How did you hear about us?
Clear selection
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?
Clear selection
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?
Clear selection
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?
Clear selection
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?

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