Fat Loss Questionaire

Fat Loss Questionaire

Many of the people who visit our site are interested in learning the fitness and nutrition skills to lose body fat and to keep it off.
If this describes you, please fill out the following form and it will automatically be sent to our personal training staff. You will be assigned a trainer who will help you to learn all of the various skills important to fat loss and body shaping.

This service is totally free.

Our trainers currently work with thousands of people in all of our various programs. Most people keep it touch through e-mail.

Thank you for your interest.

Jennifer

P.S. Click here to read my personal story regarding fat loss and how fitness changed my life.

Please be sure to put your correct EMAIL address in the space provided. It is unfortunate how many people write to us, but we can not get back to them due to incorrect information. It is impossible to respond to incorrect e-mail addresses.

Name:

E-Mail Address:

Age:

Highest weight in last 24 months:

Lowest weight in last 24 months:

Sex:

Height: feet inches

Weight

Worst body area:

...or a brief description of your physique:

Do you currently exercise: No Yes

If yes, Type of exercise you are currently involved in:

...or one we haven't listed:

Number of days per week you do this exercise:

Amount of experience in this form of exercise:

Specific goals you think you need to accomplish:

How do you feel in general:

Any medical problems or limiting injuries: No Yes

...if so, what type:

What types of food do you currently eat:

Do you currently take any type of vitamin or nutritional supplements: No Yes

...if yes, what do you take:

Any general comments that you think would give us a better idea of you, your training or your goals:

How did you learn about Betterbodz?(required)

Thanks, now all you have to do is click on the "Send To Trainers" button below to send us your completed form. Or, if you would like to start over, click on the "Start Over" buttom to erase all your answers and begin again. Thank You.

Name:
E-Mail Address:
Age:
Highest weight in last 24 months:
Lowest weight in last 24 months:
Sex:
Height:	feet inches
Weight
Worst body area:
...or a brief description of your physique:
Do you currently exercise:	No Yes

If yes, Type of exercise you are currently involved in:
...or one we haven't listed:
Number of days per week you do this exercise:
Amount of experience in this form of exercise:
Specific goals you think you need to accomplish:
How do you feel in general:
Any medical problems or limiting injuries:	No Yes
...if so, what type:
What types of food do you currently eat:
Do you currently take any type of vitamin or nutritional supplements:	No Yes
...if yes, what do you take:
Any general comments that you think would give us a better idea of you, your training or your goals:
How did you learn about Betterbodz?(required)