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New Client Application
First name
Last name
Email
Phone
Birthday
Address
Occupation
Are you in pain?
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If Yes, please elaborate.
How willing are you to change your current fitness routine?
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What is your current fitness routine like?
How willing are you to change your current diet?
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What is your current diet like?
How willing are you to remain 100% sober from drugs and alcohol while training?
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Have you taken any Functional Patterns Courses?
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What type of training interests you the most?
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Which class time works the best for you, most consistently?
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Please suggest an alternative class time that would be most convenient for you.
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How did you hear about me?
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Referral Code
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Thank you! We’ll be in touch soon.
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