Sue Kauffman Fitness Application
Congratulations on taking the first step to living the healthy lifestyle! Fill out and submit this application and I will be in touch!
First Name
Your answer
Last Name
Your answer
E-mail address
Your answer
Phone Number
Your answer
Preferred method of contact
Gender
Birth Date
MM
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DD
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YYYY
Do you have any health problems or injuries that may be a factor while we are working together?
If so, please describe here.
Your answer
Do you have any dietary restrictions?
If so, please describe here.
Your answer
Have you ever worked with a Healthy Lifestyle Planner before?
Have you been exercising regularly in the past 3 months
How did you find out about Sue Kauffman Fitness
Required
What is your favorite book or movie?
Your answer
What is your favorite TV show?
Your answer
Name 3 of your favorite foods.
Your answer
What is your favorite sport or activity to take part in? (not watch)
Your answer
Why did you choose to apply? What do you think I can help you with?
Your answer
Are you willing to invest $30 to $60 per hour in your fitness and health?
On a scale of 1-10, how committed are you to learning how to live the healthy lifestyle?
I'm going to be on fire for about 2 weeks and quit
I'm in this for the long haul! I'm ready!
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