Art Worx Personal Wellness Goals Form

Welcome to the Art Worx Personal Wellness Page

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This is the Art Worx Personal Fitness Training Program " Personal Wellness Goals Form ". You can use this page to introduce yourself, if you like, you can fill out the form below and " submit " the form which will be e - mailed to Jeffrey L. Haggans. If you wish to mail your " Personal Wellness Goals Form " Form then please mail the completed form to:

Jeffrey L Haggans
314 W. Upsal St. 2F
Phila., Pa. 19119

If you wish to print a copy please click here.

This questionnaire is designed to help identify specific wellness goals that can help pinpoint the most effective and efficient program for you.

Personal Wellness Goals Form

AREAS I WANT TO IMPROVE : (place a check in the necessary space provided)

Improving my fitness and wellness levels is extremely important to me because:

Have you participated in a fitness / wellness program before? If yes, please describe:

I was most successful in my fitness or weight loss program when...

I am committing myself to my fitness / wellness program because otherwise I would have to live with the following unbearable consequences : ( i.e. being overweight, health problems, ect.)

Participant :

Date :

If you wish to mail your " Personal Wellness Goals Form " Form then please mail the completed form to:

Jeffrey L Haggans
314 W. Upsal St. 2F
Phila., Pa. 19119

If you wish to print a copy please click here.

If you have any questions or comments feel free to e-mail me by clicking the image below.

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