Name *

First Name

Last Name

Phone

(###)

###

####

Select 1+ of the following options that apply to your training goals.

I am new to strength training.

I am recovering from an injury.

I am looking to specialize in specific sports training.

I am interested in pre/postpartum training.

I am interested in body composition change.

None of these options currently apply to me.

Do you prefer to train with a male identifying, female identifying, or no preference?

I'd prefer to work with a male trainer.

I'd prefer to work with a female trainer.

I have no preference.

How many personal training sessions are you looking to book per week?

1

2

3

4

Were you referrred to private training by a treatment practitioner? *

Yes, by an Ethos Treatment practitioner

Yes, by a treatment practitioner outside of Ethos

No

Are you injured, in pain, or interested in treatment? *

Yes.

No, not at this time.

Would you like to have a consultation call with us?

Yes!

Not needed at this time.