Your name:
Your name:
A brief questionnaire form
By: Michele K. Hanford, CPT.
hanformk@whitman.edu
509-527-5025
May I e-mail you? Your address:
May I e-mail you? Your address:
May I call you? Your number:
May I call you? Your number:
*
May I anonymously publish your question and my response in the Whitman college newsletter, The Fountain?
May I anonymously publish your question and my response in the Whitman college newsletter, The Fountain?
Yes
No
Let's talk first!
How may I help you today? Suggested topics:
• guidance on reaching your goals
• education about strength training, cardio and basic nutrition
• aches, pains, limitations you may be feeling
• accountability help
• ways to help track your progress
• equipment – please include the # of the machine!
• staff
• hours
• facility/building/grounds
• locker rooms
Your question:
Your question:
Your suggestion:
Your suggestion:
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