Dr. Kelli's STRONG FOR LIFE CLUB
Interest & Application Form
First Name
*
Last Name
*
Email
*
Phone (for text updates)
What are you most looking forward to about classes? (choose all that apply)
Improved mobility
Improved strength
Getting out of pain
Community
Would you be more interested in attending in person or virtually?
In Person
Virtually
Either
If we end each session with a dance party, what song do you want to hear?
Is there anything Dr. Kelli should know about your injury/past medical history that will be relevant in classes?
Are there other areas of your health/fitness that you need help with?
sleeping
diet/nutrition
stress management
Steps per day/general activity levels
Pain
Other (write in below)
Fill in of you selected 'Other' above
Submit