Fitness & Alignment Assessment Survey
RequiredRequired Question(s)
1.

Name:

 

50 characters left.
2.

Email ( so that we can send you your personalized nutrition tips )

 

50 characters left.
Required 3.

Can you touch your toes?

Yes easily
Almost
I have to bend my knees
Not really
I have an injury that doesn't allow me to do so.
  • Comment:

  • 500 characters left.
Required 4.

How many days a week do you exercise?

One
Two
Three or more.
I don't exercise.
Need ideas on how to sneak in exercise.
Required 5.

How many minutes are your average workouts?

10 minutes
20-30 minutes
More than 30 minutes
I don't exercise.
Required 6.

Do you have pain in any of the areas listed below?

Neck
Shoulder
Wrist/Hand
Low Back
Hips
Knees
Ankles or feet
No joint pain
Other  
7.

Would you like additional information on any of the following?

Yoga/Meditation
Pilates
Strength Training
Walking
Biking
Swimming
Running
Specific sport training list in comments
No I' good!
  • Comment:

  • 500 characters left.
8.

Thank you for sharing! Please check any of the following you would prefer to receive in addition to your personalized fitness recommendations. 

Recipes or Ideas for healthy breakfast
Recipes of ideas for healthy snacks
More information on Ketogenic Diets
More information on Gluten-Free Diets
More information on Whole 30 Diets
Other