1 / 0

Terri Fox Fitness - Client Intake Form

Fill out our client intake form to help us understand your fitness needs and preferences. Join Terri Fox Fitness for a personalized workout experience in Overland Park, KS. Contact us today!

eudora
Télécharger la présentation

Terri Fox Fitness - Client Intake Form

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TERRI FOX FITNESS 13448 w 127thst. Overland Park, KS 66212 TerriFoxFitness@yahoo.com (816) 204-1339 Client Intake Form Name ___________________________ Getting to Know You: Ideal Class Days/Times: __________________________________ __________________________________ __________________________________ What classes interest you? __________________________________ __________________________________ __________________________________ What really brought you here? Stop and think. Don’t answer until you are able to sit quietly and reflect. __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ Basic Info: Address ________________________ ________________________ Phone ________________________ Email ________________________ Birthday ________________________ Status O Single O Long Relationship O Married Spouse ________________ Anniversary ___________ Company ________________________ Job Title________________________ Starting Line: Measurements Height _______ Weight _______ Neck _______ Chest _______ Waist _______ Hips _______ Thigh _______ Arm _______ Fitness Test Pushups _____ Squats _____ Plank _____ Lunges _____ Crunches _____ Burpees _____ StepUp-R _____ StepUp-L _____
  2. TERRI FOX FITNESS 13448 w 127thst. Overland Park, KS 66212 TerriFoxFitness@yahoo.com (816) 204-1339 Payment Info Name ___________________________ All information shared will be kept secret and secure, only to be seen by staff of Fox Fitness for organizing payments of your sessions Credit Card: Number ________________________ CVV _________ Exp __________ Banking Info: Bank ____________________________ Name _______________________ Address ________________________ Acct. # _____________________ _________________________ Routing # __________________ Would you prefer: O Automatic Withdrawal O Monthly Bill OR, attach a voided check here
More Related