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(586) 778-5222 ~ 19409 E. 10 Mile Rd. ~ Roseville, Mi. 48066

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1. How did you hear about (or find) us?	driving by yellow pages searching the web newspaper flyer coupon magazine client (or friend)
1A. If you were referred, who referred you?
2.What is your service of interest?	Personal Training Athletic Conditioning In Home Training Turbo Kick Class Youth Strength & Conditioning Camp Get Fit Boot Camp Bodybuliding Figure & Fitness Contest Prep.
3. What are your areas of concern?	(Please check one or more) Weight (Fat) Loss Muscle Toning (Sculpting) Muscle Building Strength & Conditioning Endurance & Flexibility Relieve Stress (Physical & Mental) Overall Good Health
4. Are you also interested in a Nutritional Guidance Program?	Yes (for maximum results) No
5. What is your level of fitness?	Beginner Intermediate Advanced Athlete
6. How many days per week are you interested in training?	3 days (excellent for best results) 2 days (great for results and maintenance) 1 day (good for overall physical health and maintenance)
7. How long of a program are you interested in?	20 weeks (excellent) 10 weeks (great) 5 weeks (good for a start & learning)
8. When would you like to start training?	Immediately Next week In 2-3 weeks
9. When is the best time to contact you?	Anytime Morning (9:30AM - 12:00PM) Afternoon (12:00PM - 4:00PM) Evening (4:00PM - 7:30PM)
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