Customer Survey

Thank you for taking our customer survey. At Micah's Fitness we strive to give customers the best possible experience and help them reach their fitness goals!

Surveys are private and confidential. Micah's Fitness will not share your information ever.

Required values are marked by an asterisk (*)

Customer Information

Name*

Street address

City

State

Postal code

Phone number

E-mail

Where did you hear about us?
(select all that apply)

What's your favorite workout split?

How many times do you workout per month?

Check this box if you can bench press 225lbs

Contact Us

If you have any questions or need more information, feel free to reach out to us:

Micah's Fitness Gym

Address: 123 Fitness Lane, Conway, AR 45678

Phone: (123) 456-7890

Email: info@micahsfitness.com

Internet
Some random dude at the gym
Newspaper