I'm interested in Personal Training!-Pacific Clinic

First Name

Last Name

Email

Phone Number

How often are you currently working out?

Daily

2-3x/week

Once a week

Rate your current level of fitness

What day(s) are you available to meet with a trainer? Check all that apply.

What times of day work for you? Check all that apply.

Mornings

Afternoons

Evenings

What are your fitness goals? Check all that apply.

Do you have any specific body parts you would like to train?

Is there specific equipment you would like to learn to use?

Do you have any existing injuries or health conditions that we should be aware of while building your training plan?

By providing your phone number, you agree to receive text messages from The Pacific Clinic and the Center for Functional Health. Message and data rates may apply. Message frequency varies. You can opt-out at any time by texting STOP, for any help visit www.pacific.clinic/policies