EmailMe Form - JD Fitness 360

Thank you for choosing JD Fitness to be your personal/online fitness trainer. Your committment to your future health, fitness and nutrition is now in your hands and JDF360 is here to help you along the way.

This questionnaire/registration will help me better understand your needs, goals, and put together a customized program that will best suit you.

Tell me how you feeling before getting started.

Which option BEST describes your current situation? *

I have a lot of weight to lose (30+ lbs)

I have a lot of weight to lose but stuck at those 10 - 15 lbs

I'm ok with my weight, but want to build muscle and gain mass

What activity/hobby energizes you? *

Ex. I like to play flag football in my spare time.

Training Experience *

Beginner (0 - 1 year)

Intermediate (2 - 4 years)

Advanced (5 + years)

What has work well in the past? *

Such as Do you work well with dumbbells or resistance bands.....?

What has not worked well? *

If you not able to perform a squat, there's always an alternative......

What do you struggle with the most? *

Ex. I have trouble with cutting back on drinking coffee.

What program interest you the most? *

Weight Loss/Shred (Lose fat)

Bodybuilding (Builds muscle)

Cardio (Improves endurance)

Strengthening/Conditioning (Athletic training)

How many days out the week are you willing to see your trainer? *

How is your eating habit? *

Ex. I eat a lot of bread.

Name *

First Last

Email *