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Please answer the questions below so I can learn more about your goals.



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Are you a male or female?
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Female

What is your age group?
I am in my 20's
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I am in my 40's
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I am in my 70’s or older

Are you a health professional?
Yes
No

What is your main health & fitness goal?
Lose Weight/Fat or Get In Shape
Get Stronger or Build Muscle
Overcoming Current Injuries
Longevity, Safe Training and Energy

What pain or injury do you need help with? (choose one or more):>
Neck Pain
Shoulder Pain
Elbow Pain
Wrist & Hand Pain
Back Pain
Hip Pain
Knee Pain
Foot & Ankle Pain

Do you have any health concerns?>
Do you have/are you concerned about Diabetes? (CHECK IF APPLIES)
Do you have/are you concerned about Alzheimer’s? (CHECK IF APPLIES)
Do you have/are you concerned about Heart Disease? (CHECK IF APPLIES)
Do you have/are you concerned about Muscle Pain? (CHECK IF APPLIES)
Do you have/are you concerned about Vision Health? (CHECK IF APPLIES)
Do you have/are you concerned about Joint Pain? (CHECK IF APPLIES)

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Central or South America
Australia or Surrounding Area
Asia or Africa

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