Pre-Screen Questionnaire Form
Name
(Required)
First
Last
Email
(Required)
Phone
Which City are you From?
Vaughan
Maple
Richmondhill
Woodbridge
Thornhill
King City
Other
How Old are You?
How did you Hear About Us?
Social Media (Facebook, Instagram, etc)
Google Search
Member Referral
Plaza Visit
Other
If Referred by a Member, who referred you?
What goals are you looking to achieve over the next 6 months? Please be specific.
Why are these goals important to you? Please be specific.
How will achieving these goals positively impact your life?
What are your current challenges and/or hesitations?
To determine your daily activity level, what is your occupation, or what type of work do you do?
Do you have any current medical conditions/injuries you are working around or trying to rehab that may get in the way that I can help with?
How active are you currently or within the last 6 months to a year?
I don’t currently exercise
A Few Times a Month
Beginner I exercise maybe 1x week
Intermediate I exercise 2-3x week
Advanced I exercise 4-5x week
Joining our Gym requires a financial investment. That being said, which best describes you?
I’m 100% committed to invest whatever it takes to finally level up health, my body & my life!
I can financially invest some funds as I’m on a limited budget.
I’m not prepared to invest anything in myself at all.
Are you the final decision maker in regard to joining my program?
Yes, Im ready & 100% able to make this decision on my own
No, I need approval from someone else (spouse, etc.)
When making this booking you commit to showing up ready and on time to the best of your ability.
YES! This is important to me & I understand my responsibility to show up on the day and time that I booked.
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