Name *

First Name

Last Name

Phone *

Please leave the best time to call in the comment section.

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I am interested in: *

If desired, please include preferred location for assessments/trainings in the comment section. i.e. North-End or Community Center.

Wellness Consultation – Let’s discuss your wellness goals, see where you're at, and come up with a plan that fits

Personal Training – With 1-on-1 time, you'll get the skills and motivation you need on your wellness journey

Nutritional Guidance – Need direction? Get personalized meal planning and nutritional information

Body Composition Analysis – Step on our InBody 570 to see where you’re at - and where you're going.

Wellness Center Orientation – Never been in the gym? Let us show you how it’s done

Greater Sports Performance

Assessment Time:

What time of day would you prefer your assessment?

Morning (6:00 am – 12:00 pm)

Afternoon (12:00 – 4:00 pm)

Early evening (4:00 – 8:00 pm)

How do you prefer to be contacted?

Phone

Email

Carrier Pigeon

Smoke Signals

How did you hear about Greater Midland Personal Training?

Greater Midland staff

Family/Friend

Social Media

Email

Billboard

Television

Radio

Did you receive a referral card?

Yes

No