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I'm looking forward to meeting you
I value your time, so please answer these questions before we meet (All questions are required to be answered).
Cycle Pain-Free Form
Full Name
Email
Phone
Country
What is your dream goal for working with me?
Why is that important to you?
How long have you had aches &/or pain?
Do you think you can beat your pain on your aches &/orown?
Do you want to sustain your result after you achieve it?
You already know it’s not easy to overcome aches & pains. Will you take my recommendations and do what I ask in order to help you reach your goal?
Are you able to workout twice per week?
*
Yes
No
Why are you applying now?
Why do you think you'll succeed with this program?
On a scale of 1 – 10, 1 being no pain at all and 10 being so painful that you are unable to do anything; in the past seven days: - What is the worst back pain you have had?
- What is the average pain you have? (1-10)
- How much has pain prevented you from doing your usual activities? (1-10)
My average client reduces their aches & pains by 60% or more in the first 6 weeks. Are you ok with that?
*
Yes
No
Have you struggled with maintaining self-directed exercise in the past?
*
Yes
No
Do you think you'll be more successful with an expert helping you along the way? Why?
Do you think you'll be more successful with daily accountability?
*
Yes
No
Is it more important that you get rid of your pain quickly or that it’s permanent?
*
It's more important for me to get rid of pain quickly
It's more important for me to get rid of pain permanetly
What is your timeline for getting started?
*
As soon as possible
3-6 months
Just evaluating my options
If the program solves your aches & paina and helps you get stronger will you be willing to commit to workout with me 2x per week?
*
Yes I'm willing to commit to doing the work
No I'm not ready to do the work
Is there anything else you want to share with me?
How did you find out about the Cyle Pain-Free program?
*
Referral
Google search
Facebook ad
Other
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