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* 1. How often do you work out per week?

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* 2. What kind of exercise do you regularly do? Check no more than three.

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* 3. Do you usually work out:

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* 4. Are you working out more or less than you did 5 years ago?

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* 5. One year from now, do you plan to be working out more or less than you are now?

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* 6. What type of fitness/activity do you want to try in the near future?

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* 7. If you work out regularly, what's the main reason you do so?

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* 8. If you don't work out regularly, what's the main thing that prevents you from doing so?

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* 9. What is one question you'd like to have answered about exercise and fitness at your age?

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* 10. Where do you most often get your information about fitness and exercise?

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* 11. What type of fitness/wellness vacations are you interested in? Check all that apply. 

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* 12. Please enter your age

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* 13. Your name

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* 14. Your email address please. 

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