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Infinity Health & Wellness
Please fill out all answers as honestly as possible as this helps us create a plan specific to your needs
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1. What is your name?
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Your answer
2. Age & Weight? (Must be over 18)
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Your answer
3. What is Your email & Phone #
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Your answer
4. What does your current fitness routine consist of? (days per week, exercises you do, etc)
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Your answer
5. What does your current meals consist of?
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Your answer
6. Do you have any past or current injuries? If yes, please explain.
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Your answer
7. Do you have any medical conditions that will affect your training? If yes, please explain any information your doctor has said in regards to working out and Nutrition
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Your answer
8. In a year from now, what's your dream body look like? (please be specific, such as weight, body fat percentage, etc)
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Your answer
9. How much progress towards your fitness goals did you make last month?
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Your answer
10. What roadblocks are slowing you down from reaching your fitness goals
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Your answer
11. Do you have a personal trainer or are following a specific program you found/bought? If yes, please tell us what the program is or what your trainer has you do.
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Your answer
12.
How is your fitness progress going? (Most are in one of 3 places)
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Poorly (zero to no progress)
Struggling (some progress, but not as fast as you'd like)
Successful (good progress, just looking to sustain it)
13. If you could begin making fast progress towards your fitness goals, would you be interested?
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Yes
No
Maybe
14. Which one best fits you?
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I want something free or a trial first
8
Money is a bit tight but I will make it work!!
SIGN ME UP, I WANT TO INVEST IN MYSELF! I'M READY!
Other relevant thoughts or comments you wish to share?
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