client survey – CWRT

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First name *

Last name *

Email Adress *

Phone Number (Optional)

Zipcode *

City *

State *

Age *

Gender *

Male
Female

How would you describe your current health and fitness level?

Checkboxes

Crawl - Just starting/need to know where to start
Walk - Know the basics but looking for guidance
Run - Built the habit and ready to take it to the next level
Thrive - At the top of your game and prepared to figure out how to get even better
Select All

What are your current goals?

what

Lose weight
Gain muscle
Improve overall health
Increase athletic performance
Select All
Other

Single Line Text

When thinking about your health and fitness, what excites you most?

* Select only 2 fields.

Feeling strong
Looking fit
Feeling pain-free
Performing at a high level
Pushing your body to new limits
Knowing what your body is capable of
Other

What type of exercise are you interested in?

What type of exercise are you interested in?

Bodybuilding
Olympic Lifting
Crossfit
Yoga
HIIT
Running
Sport Training
Other

Have you ever had an experience with a coach/trainer?

Have you ever had an experience with a coach/trainer? *

Yes
No

Do you prefer in-person or online coaching?

Multiple Choice *

In-person
Online
Either

How many days a week would you like to exercise?

How many days a week would you like to exercise? *

1-2 days
3-4 days
Five or more days

What is your monthly budget?

Give this a try ($0 - $100)
A few sessions a month ($100 - $250)
A few sessions a week ($250 - $500)
No limits (500+)

Do you have any medical conditions or special dietary restrictions that your coach should know?

Do you have any medical conditions or special dietary restrictions that your coach should know? *

Yes
No

What gender of coach would you prefer?

Multiple Choice *

Male
Female
No preference

Do you have any specific preferences or expectations for your coach?

Multiple Choice (copy) *

Yes
No

Complete Registration

Email *

Password *

Password

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