The Basics
Hello and welcome, let's get to know you...
Full name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Introduction - Welcome to our facility
Where did you hear about us?
Social Media
Google Search
Friend/Family
Recommended By Someone Else
Walked Past
Print Advert
Event
Other
Let's Get Going
Some basic lifestyle items first...
How good would you say your diet is?
1
2
3
4
5
How would you rate your rest/sleep?
1
2
3
4
5
How stressful is your job/lifestyle?
1
2
3
4
5
Keep Moving
Let's dive into the real support structures..
Out of 5 how good do you feel now in relation to your health and fitness?
1
2
3
4
5
How important is it for you to create change?
1
2
3
4
5
Are you currently exercising?
Not Consistently Weekly
1 time per week (most weeks)
1-2 Times weekly
3-5 Times Weekly
5+ Times Weekly
Not at all
Other
What Motivated you to come here today?
I'm fed up of not taking action
Doctor or allied health advised
You've been highly recommended
Not a fan of big gyms
Need a more private style of training
Can't do regular gym work due to injury
Other
How long have you been thinking about getting into some fitness or changing your fitness routine?
Less than 1 Month
1-3 Months
3-6 Months
6-12 Months
1-3 Years
3 Years+
What's stopped you from taking action before?
Time
Money
Busy Lifestyle
Procrastination
Location
Motivation
Other
What two of the below would you like to achieve?
Fitness Increase
Better Energy
Weight Loss
Strength Gain
Improved Health (Mental/Physical)
Tone Up
Habit Creation
Lifestyle Adjustment
Outline your main goal below?
Why is this your big goal?
How important is your goal?
1
2
3
4
5
Do you have a timeline to achieve the above goals?
1-3 Months
3-6 Months
6-12 Months
12 Months +
Lifestyle
Specific Deadline
Other
What is most important for you? (Top two)
Caring coaches
Support and Accountability
Motivating Staff
Guidance and learning
Private Environment
Training around Injuries Properly
Results
Other
What exactly is EMS?
We will outline the how behind the tech and what it does now...
Let's Tour the Club
Let's Go for a quick club tour...
If doing trial (suit up time)
The Future You
Let's Look at You and Who You Can Become!
Membership Options
Précédent
Suivant
Signature
Take Photo
Payment info/setup
We will now set you up on our membership system
Submit
Before we forget - We must give you your VIP Guest Pass too as a part of our membership gift!
Our gift to you for taking action - 1 X FREE 3 PACK
Which Friend or Family Member Comes to Mind?
Should be Empty: