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Transitions Studio Intake Form
Date of Birth:
How did you hear about us?
What program(s) are you interested in? (Select all that apply)
Functional Fitness for Older Adults Exercise Class
Weight Management Bariatric Conditioning Program
Dynamic Movement and Balance Class
Ease into Exercise Program for Individuals with Chronic Pain
Please describe your daily activity level.
Do you have a current membership at any fitness center?
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