Thank you so much for your interest in our program and taking the first step to a healthier and happier life. There are just a few things we need to know about you before we begin.



Full Name
Date of birth

In order to make sure we don't waste your time, I want to ask you some questions to prequalify you for our fitness program. The following questions will show us whether our program is right for you:



Our mission is to provide you with a fitness program that improves your overall lifestyle, so that when you reach your goal with us.. you will MAINTAIN it for however long you desire. Statistics prove that when you practice something new for 3 months or longer, you are more likely to make it a habit…. even if you get you to your goal in less time.


IF...you are willing to do what we have asked, then we can not wait to help you improve the quality of life…more energy, better mood, better sleep, better tolerance of stress and (of course) get to your goal and get into the BEST SHAPE OF YOUR LIFE.

Please make sure you have answered ALL questions. When you are done, please click the submit button below. I will review your form and contact you within 24 hours to review rates and possibly set up an appointment.


Form View Counter