Schedule Your Smart Start

A Smart Start is a great way to get more in-depth instruction and direction to help you get started on your personal health and wellness journey. Goals, proper form, strength training and a customized workout plan are some of the key deliverables of this coaching program.   
First Name
Last Name
Age
Preferred Phone (xxx-xxx-xxxx)
Email
Regarding your own personal health and wellness, what would you like to focus on (check all that apply):
 Flexibility | Mobility | Stability
 Weight Loss
 Strength
 Cardiovascular Health or Running
 Sport Performance
 Overall well-being and health
 Nutrition
 Mind & Body
 Other
What are your specific health and wellness goals and why?
What are you currently doing to accomplish your goals? What is your routine?
Have you exercised in the past? If so, please describe how long ago and what your exercise regimine included.
Please share any medical limitations, injuries or past health history and information that would beneficial for us to know as we get you started on your program at the Y.
Days available to schedule Smart Start (check all that apply):
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday
Times Available for Smart Start:
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