First Name
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Last Name
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Email
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Phone
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Age
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31-39
40-49
50-59
60-69
70+
Other
What compelled you to reach out to us?
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A friend told me how awesome you are
I know people who are members that workout here
Social Media
I heard you on a podcast/TV/Radio
Online Search
Other
What's the big goal? If we're sitting here 12 months from now looking back on our time working together, what would have to have happened over that period of time for you to be absolutely THRILLED with your progress?
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What types of things have you tried to solve this problem in the past? Be as detailed as possible. We want to know everything you've tried so we can make sure you never have to add to that list again 🙂
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Private 1-on-1 Personal Trainer
Bootcamp Classes
24-Hour Gym/Health Club
At-Home DVD's and DIY Workouts
Diets/Supplement Programs
I can't remember the last time I did ANYTHING!!!
What's stopped you from solving this yourself? What are the roadblocks that have kept you from hitting that goal after all this time? (Check all that apply)
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Making Time in my Weekly Schedule
Lack of expert Coaching and Guidance specifically tailored to my needs
Finding a Proper Training Program for my Needs
Lack of Energy
Inconsistency with my Nutrition and Eating Habits
Not feeling comfortable in a fitness setting
Nagging Injuries and Pain
All the Above
Does your spouse or significant other support you? (i.e. will they give you a thumbs up on whatever you decide?)
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Yes
No
N/A
With your schedule, what is the most ideal time for you to exercise? Check All That Apply
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Early Morning (before 8am)
Mid-Morning (8:30am-Noon)
Late Afternoon/Evening (after 4pm)
My schedule is rather flexible
Which PowerStrength Location Works Best For You?
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Alpine - 919 Alpine Commerce Park NW
Kentwood - 5131 E Paris Ave SE
Jenison - 1308 Rosewood St.
Plainfield - 5246 Plainfield Ave NE
Tell Us More About You and Your Goals. How Can We Help You?
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By Checking this box you acknowledge that you have completed this inquiry with intentions on improving your overall fitness, health, and well-being. You also acknowledge that after completing this page, you will follow the prompt to self-schedule a brief call with a PowerStrength representative to review how we can best tailor a program for your goals and needs. Note that space is often limited in our program. Those who schedule promptly have the best chance at the training slots that fit their schedule. We look forward to speaking with you!
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