NEW CLIENT SURVEY

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PERSONAL AND SMALL GROUP TRAINING
NUTRITION COACHING
- 3 month Nutrition Coaching Questionnaire
ABOUT ME
YOGA

HOME
PERSONAL AND SMALL GROUP TRAINING
NUTRITION COACHING
- 3 month Nutrition Coaching Questionnaire
ABOUT ME
YOGA

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YOUR CART

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NUTRITION

TELL ME ABOUT YOURSELF.
Please fill out this survey to get the ball rolling. I will get back to you within 48 hours. Can't wait to meet you!

* Indicates required field

Name *

First

Last

Your email address: *

Phone Number: *

What private service are you interested in? *

Private Yoga Private Training Dual Training Small Group Training Nutrition Coaching

Please note that if you're interested in Dual or Small Group Training, we do NOT assign you to a group, you must join with an interested partner or small group.

If training or yoga, would you like to work virtually over Zoom or in person? *

Zoom, please. In person would be great. A little of both.

How many days of the week would you like to train? *

1 time per week 2 to 3 times per week 4-5 times per week

How long would you like to train? *

45 minutes 60 minutes

What is your age? *

What days and times are you available to meet? Please list all possible options, but be sure that these are times that you can commit to with ease, for the most consistency possible. *

Have you had any heart issues, recent surgeries, injuries, diabetes, dizziness, fainting, pregnancy, or other health issues that would effect your workouts? *

Yes No

If yes, please specify: *

What can I help you with? Dig deep and tell me about why you have sought out help. No answer is wrong or too long! *

Submit

SHAKTI FIT

shaktifit@yahoo.com
419-957-1997
20495 Arrington Road Utica, Ohio

YOGA. TRAINING. NUTRITION.

YOUR CART

Let's get started!

TELL ME ABOUT YOURSELF.Please fill out this survey to get the ball rolling. I will get back to you within 48 hours. Can't wait to meet you!

TELL ME ABOUT YOURSELF.
Please fill out this survey to get the ball rolling. I will get back to you within 48 hours. Can't wait to meet you!