Nuffield Health

First Name *
Last Name *
Email *
Phone Number *
Preferred Date of Visit DD / MM / YYYY
Do you?
Work Locally Live Locally
How did you hear about Nuffield Health Moorgate ?
Are you currently following a regular exercise programme?

Yes
As someone not following a regular exercise programme, when did you
last exercise regularly? DD / MM / YYYY
Why did you stop?
Which of the following would you like to partake in?
Personal training Swimming Weight training HIIT (High Intensity Interval Training Yoga/Pilates Power Plate Squash Golf Spa Treatments Wellness Services (Physiotherapy, Osteopathy, Sports Massage, Acupuncture etc_
What would you ideally like to achieve by joining Nuffield Health Moorgate?
Maintain Fitness Improve Fitness Lose Weight Gain Muscle Tone Up Stress Reduction Rehab General Wellbeing
Is there a particular reason / event / timescale for this?
What areas / services of the Club do you anticipate using the most?
Cardio Equipment Resistance Group Exercise Swimming Power Plate Spa
What time(s) of day would you be likely to use the club?
Mornings Lunchtime After work Weekends
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