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Please answer the questions below so I can learn more about your goals.
Email Address:
Are you a male or female?
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Female
What is your age group?
I am in my 20’s
I am in my 30’s
I am in my 40’s
I am in my 50’s
I am in my 60’s
I am in my 70’s or older
Are you a health professional?
Yes
No
What is your main health & fitness goal?
Lose Weight/Fat or Get In Shape
Get Stronger or Build Muscle
Overcoming Current Injuries
Longevity, Safe Training and Energy
What pain or injury do you need help with? (choose one or more):
Neck Pain
Shoulder Pain
Elbow Pain
Wrist & Hand Pain
Back Pain
Hip Pain
Knee Pain
Foot & Ankle Pain
Do you have any health concerns?
Do you have/are you concerned about Diabetes? (CHECK IF APPLIES)
Do you have/are you concerned about Alzheimer’s? (CHECK IF APPLIES)
Do you have/are you concerned about Heart Disease? (CHECK IF APPLIES)
Do you have/are you concerned about Muscle Pain? (CHECK IF APPLIES)
Do you have/are you concerned about Vision Health? (CHECK IF APPLIES)
Do you have/are you concerned about Joint Pain? (CHECK IF APPLIES)
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