Feedback Form

Please note that this is anonymous, however if you would like me to follow up with you, please leave your name below.

First Name

Last Name

Are there any exercises/movements you are currently doing that you would like to change?

Do you have any recent specific physical issues or concerns?

Yes No

If yes, please explain:

Do you feel like you are being pushed?

Too hard Just right Not enough

Do you feel like you are making progress towards your goal(s)?

Yes No

If yes, please explain:

What areas of your current fitness program and coaching relationship do you feel could use improvement?

How likely are you to refer JR Training Systems to a friend or family member?

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