Treatment Information (required)

Ability to Schedule a Convenient Appointment: Excellent Very Good Good Fair Poor

Overall Appearance of Clinic: Excellent Very Good Good Fair Poor

Overall Appearance of Staff: Excellent Very Good Good Fair Poor

Staff was Courteous and Friendly: Excellent Very Good Good Fair Poor

Quality Time Spent With a Trainer: Excellent Very Good Good Fair Poor

Would You Return to this Facility Should You Need Services: Yes No

Would You Recommend Our Services to Another Person: Yes No

Specific Fitness Service Personal Training Sports Conditioning Medical Weight Management Small Group Training Aquatic Traning Team Training PEP Program

Personal Information (optional)

Full Name:

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