KICKSTART Fitness - Consultation Request



			HOME \| ABOUT KS FITNESS \| SERVICES \| NEWS CENTER \| RATES \| CONTACT US

Consultation

Arranging a personal consultation with a fitness expert is easy.

Simply complete this form so we can learn a little bit about you first.

After filling out this consultation request form you can expect to hear from us within 48 hours to schedule an appointment.

Sincerely,

Jason Fisher
Executive Fitness Consultant
KICKSTART Fitness

Arrange a Personal Consultation

[* indicates a required field]

Name:	*
Address:
Phone:	*
Email:

How often do you exercise?

In which activities do you presently participate?

FITNESS BENEFITS What fitness benefits would you most like to accomplish? *
Lose weight	Increase energy	Gain weight
Firm & define	Reduce stress	Increase flexibility
Gain inches	Maintain shape	Reduce health risks
Reduce pain	Increase strength	Trim inches
Sport specific training		I'm not sure

Do you suffer from any of the following? *
Pain or stiffness in: Back Knees Shoulders
Arthritis	Heart disease	Weight problems
Asthma	Fybromyalgia	Depression
Osteoporosis	High/Low BP	No known ailments
Other:

Rate your nutritional habits on a
scale of 1(poor) to 5(excellent):

PERSONAL REVIEW Which of the following could I do for you in order to help you achieve your goals?
Motivation	Increase participation
Nutritional guidance	Commit to program
Preplan workout	Advance past plateaus
Increase time efficiency
Other:

KICKSTART Fitness
416.812.0009
info@kickstartfitness.com

About Your Privacy
Kickstart Fitness will not share personal contact information or details provided in the online consultation form with any third parties for any purpose whatsoever. Information is used for the sole purpose of informing and arranging consultations and will not be used for unsolicited email or other communications at any time.