Thank you! Please fill out this survey so we can get to know more about you! Name * First Name Last Name Email * Phone Number (###) ### #### Occupation List and/or describe your goals as they pertain to joining this program What do you want to do in 6 months that you cannot do today? Do you currently have an exercise routine? If yes, describe the type of activity, days/week, minutes/day. List any equipment available to you. Thank you!