Personal questionnaire

Welcome to synergy Health Living!

In an effort to ensure quality service we would like to learn a little about you by filling out this short survey. Synergy Healthy Living strives to reach everyone's health and fitness goals by constantly integrating new resources and techniques for our consumers.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

Contact Information

* First Name :

* Last Name :

Address 1 :

Address 2 :

City :

State :

Zip :

* Phone :

* Email Address :

* What brought you in for training?

* Areas you would like to target:

* Preferred method of training:

what type of music do you like to listen to when you workout?

what are some reasons that has inhibited you from reaching your fitness goals in the past?

What are issues you experienced at other gyms?

What are you hoping to experience at Synergy Health Living?

Select groups that you might be interested in learning more about.