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2015
July
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Name:
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Email Address:
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Which service did you sign up for?
Neurology 101 (for athletes)
Neurology 101 Intensive Coaching
Functional Diagnostic Nutrition
Personal Training
Other
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Was you desired outcome or goal accomplished? If yes, or no, please describe
How would you rate the following:
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
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Your Coach clearly understood what was important to you, your goals and your desired outcome
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You felt that your Coach cared about you, your progress, your desired outcome and your experience with us
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You understood what exercises you were expected to do on your own, how often, how to and when to do them
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You felt confident doing the exercises on your own ("homework")
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You felt expectations for "Homework" were reasonable
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You knew HOW the exercises assigned to you would help you achieve your goals or desired outcome
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You made progress towards your goals or desired outcome
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You achieve your desired outcome or goal
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You identified that you achieved your goals or desired outcome with the help of Brain Based Fitness
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You were treated with respect during each interaction with the Brain Based Fitness team
Is there anything we can do to improve our services, offerings, business model or pricing?
What do you feel we did do that contributed to your success?
Are you willing to to refer us to a friend?
Willing to Refer
Not Yet
Is there anyone you know who may benefit from our services?
Yes
No
If so, would you be willing to ask them for their permission for us to contact them and invite them to a free consultation?
Yes
No
All responses are kept private and confidential. Information collected will be used to improve our operations, client experience and employee training. Any information shared in the process will not include your identity or information that could be used to identify you.
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