Lifestyle survey - Comprehensive Health & Fitness

Lifestyle surveyadmin2023-08-23T15:57:38+10:00

Understanding your Health & Fitness needs

Name

Email address

Phone number

Are you satisfied with your current health and fitness levels?

Yes

If you answered No please specify the reasons behind your dissatisfaction:

If you answered Yes would you be interested in discussing ways to further improve your well-being?

What factors are hindering your progress towards becoming a healthier version of yourself? Please select all that apply:

Time Management

Stress

Pain

Lack of Knowledge

Bad Habits

Not prioritising myself

Lack of Progress

Other

(please specify)

Other (please specify)

What steps have you taken to enhance your health and fitness?

Is there a particular aspect of your physical fitness that you wish to improve? Please select all that apply:

Fat loss/Weight Management

Strength

Muscle Building

Cardiovascular Health and Fitness

Joint or Muscle Issues

Overall Quality of Life

Lack of Progress

Other

Apprehension Towards Exercise (Resistance training)

Aggravated Injuries

Preventable Chronic Conditions

Other

(please specify)

Other (please specify)

What is your primary goal in working with us?

What significance would achieving this goal hold for you?

Thank you for your message. It has been sent.

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Contact

+61 412 032 341
enquire@chafitness.au
PO Box 123, XXX

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