Name * First Name Last Name Email * Age * Phone Number * Goals * (check all that apply) Weight Loss Muscle Gain Tone Strength Diet What are your fitness goals for the next 90 days * What has been your biggest obstacle in fitness? * On a scale from 1-5 how important is it to you to reach these goals? * 1 being not important at all and a 5 being very important On a scale of 1-5 how ready are you to make a significant financial investment in your health and fitness? * Thank you!