J's Gym - Next Level Fitness

Free Consult

Interested in improving your personal fitness? Complete the Free Consult request form below and submit it today. After submitting your information, please call the gym at 410-825-3600. Be sure to leave a message. Someone will contact you within 48-hours to schedule your appointment.

*  =  Required information

 

Personal Information
*First Name: 
*Last Name: 
*Address1: 
Address2: 
*City/Town/County: 
*State: 
*Zip Code: 
*Home Phone: 
Work Phone: 
Cell Phone: 
*E-mail: 
Client History
Birth Date: 
Height: 
*Present Weight: 
Years at Present Weight: 
Highest Weight: 
Desired Weight: 
How many days per week are you currently doing aerobic exercise-i.e., walking, treadmill, bike, etc.? 
Desired Goals
What time of day would you like to train? 
Where do you rate health & fitness in your life?   


What would you Specifically like to change or improve with your physique or figure? 
Would you be interested in nutritional information? 
 
 

 

 

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Phone: 410-825-3600
E-mail: info@jaysnextlevel.com