What works for YOU?
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1. Default Section
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1
. What are your health and fitness needs? (You may choose more than one answer.)
What are your health and fitness needs? (You may choose more than one answer.)
Lose weight
Tone/reshape
Improve posture
Improve balance
Increase flexibility
Reduce or relieve pain
Improve endurance and stamina
Enhance athletic performance
Other (please specify)
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2
. How would you describe your current fitness level?
How would you describe your current fitness level?
Very Fit/Athlete
Actively exercise at least 4 times per week
Active in daily life, but do not exercise
Sedentary
Significant Weight, Health or Other Concerns
Comment
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3
. What day of the week works best for your current schedule for group classes? (You may choose more than one answer.)
What day of the week works best for your current schedule for group classes? (You may choose more than one answer.)
M
Tu
W
Th
F
Sa
Comments
4
. What time of day do you prefer for group fitness classes? You may select more than one answer.
What time of day do you prefer for group fitness classes? You may select more than one answer.
Early Bird 5:15am
Morning 8am
Morning 10am
Afternoon 1pm
Early Evening 4pm
Evening 5:30pm
Evening 6:30pm
Other, please specify
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5
. To better serve you, please fill in the following information:
If you are interested in hostessing an event in your area and receiving hostess discounts and rewards, contact Carol at rejoice@aeroinc.net.
To better serve you, please fill in the following information: If you are interested in hostessing an event in your area and receiving hostess discounts and rewards, contact Carol at rejoice@aeroinc.net.
Name:
Company:
Address:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
Country:
Email Address:
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6
. Are you interested in specialty classes? If so, which ones?
Are you interested in specialty classes? If so, which ones?
Ease Into Exercise
Beginner T-Tapp
Intermediate T-Tapp
Advanced T-Tapp
Nordic Walking
Floor
Tone to Tunes Variety Workout
Outdoor Fitness
Other (please specify)
7
. How would you rate your previous exercise program experiences?
Aggravated injuries
Not helpful
Helpful initially only
Helpful/boring
Helpful/ enjoyable
Met goals
Exceeded goals
Fitness equipment
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How would you rate your previous exercise program experiences? Fitness equipment Aggravated injuries
Fitness equipment Not helpful
Fitness equipment Helpful initially only
Fitness equipment Helpful/boring
Fitness equipment Helpful/ enjoyable
Fitness equipment Met goals
Fitness equipment Exceeded goals
Weight training
Weight training Aggravated injuries
Weight training Not helpful
Weight training Helpful initially only
Weight training Helpful/boring
Weight training Helpful/ enjoyable
Weight training Met goals
Weight training Exceeded goals
Personal training
Personal training Aggravated injuries
Personal training Not helpful
Personal training Helpful initially only
Personal training Helpful/boring
Personal training Helpful/ enjoyable
Personal training Met goals
Personal training Exceeded goals
Group fitness classes
Group fitness classes Aggravated injuries
Group fitness classes Not helpful
Group fitness classes Helpful initially only
Group fitness classes Helpful/boring
Group fitness classes Helpful/ enjoyable
Group fitness classes Met goals
Group fitness classes Exceeded goals
Diet programs
Diet programs Aggravated injuries
Diet programs Not helpful
Diet programs Helpful initially only
Diet programs Helpful/boring
Diet programs Helpful/ enjoyable
Diet programs Met goals
Diet programs Exceeded goals
Comments
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8
. How did you hear about training with Carol?
(Thank you for taking time to fill out my survey!)
How did you hear about training with Carol? (Thank you for taking time to fill out my survey!)
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