Contact PT Refined

Longwood Training Center
Village Fitness Center
At the intersection of I4 and SR 434
(407) 252-2611

Winter Park Health and Fitness
1560 Orange Ave, Lower Level
Winter Park, FL 32789
(407) 252-2611

Your Name*
Your Email Address*
Telephone*
Training location of choice*	Downtown Orlando Winter Park Altamonte Springs In Home or Office Other Location
I want to work on*	Weight Loss    Increased Energy     Thigh Area     Buttocks Area     Abdominal Area     Arms     "Love Handle" Area     Enhanced Sex Life     Better Nutrition     Depression     Other (See Comments)
If weight loss is a goal, how much would you like to lose?
List any medical conditions you would like to discuss
Has a Certified Trainer ever created a customized fitness and nutrition program for you?	Yes     No
How soon do you want to reach these goals?	1 to 3 months 3 to 6 months 6 to 9 months 1yr or longer
Additional comments
How did you hear about us?	Client Referral Google Yahoo MSN Radio Mall Advertisement Magazine Article Word of Mouth Other
Would you like to join our Free eNewsletter?	Yes, I want to join and know that I can unsubscribe at any time.     No, I do not want free health and fitness tips emailed to me.
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Altamonte Springs Training Center
224 W. Central Parkway Blvd
Altamonte Springs, FL 32714
(407) 252-2611

Winter Park Health and Fitness
1560 Orange Ave, Lower Level
Winter Park, FL 32789
(407) 252-2611