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Please answer the following questions so I can better understand your situation, and your goals.
Your Email Address
What is your gender?
Male
Female
What age group are you in?
I am in my 20's
I am in my 30's
I am in my 40's
I am in my 50's
I am in my 60’s
I am in my 70’s or older
Are you a fitness trainer, physical therapist, or other health professional?
Yes
No
Which health & fitness goal is MOST IMPORTANT to you right now?
Lose Weight/Fat or Get In Shape
Get Stronger or Build Muscle
Overcoming Current Injuries
Longevity, Safe Training and Energy
What pain or injury do you need help with? (choose one or more)
Neck Pain
Shoulder Pain
Elbow Pain
Wrist & Hand Pain
Back Pain
Hip Pain
Knee Pain
Foot & Ankle Pain
Do you have any health concerns? (choose one or more)
Do you have/are you concerned about Diabetes? (CHECK IF APPLIES)
Do you have/are you concerned about Alzheimer’s? (CHECK IF APPLIES)
Do you have/are you concerned about Heart Disease? (CHECK IF APPLIES)
Do you have/are you concerned about Muscle Pain? (CHECK IF APPLIES)
Do you have/are you concerned about Vision Health? (CHECK IF APPLIES)
Do you have/are you concerned about Joint Pain? (CHECK IF APPLIES)
Where do you live?
USA
Canada
Europe
Mexico
Central or South America
Australia or Surrounding Area
Asia or Africa
