Client Name: *
Age: *
Email Address: *
Phone Number: *
How do you prefer to be contacted: *	----EmailPhone
Please choose your facility: *	----Dahl Y ( La Crosse )Houser Y ( Onalaska )
Why are you interested in training?	Athletic Enhancement  Building Mass  Strength  Toning  Weight Loss  Other
What gender trainer would you prefer working with? *	----No PreferenceMaleFemale
When would you like to start training? *
What is your desired training schedule? *	Early morning (5am-7am)  Morning (7am-11am)  Lunch (11am-1pm)  Afternoon (1pm-5pm)  Evening (5pm-10pm)
Is there a personal trainer you would prefer to work with?
Please list any concerns that you would like your trainer to know prior to the initial meeting: *

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