1) How much do you want to pay for a treadmill?

Under $1000
$1000 - $2000
$2000 - $3000
Over $3000

2) Do you want advanced workouts, such as jogging up and down hills, etc.

Yes   No

3) Do you want a heart rate monitor?

Yes   No

4) How old are you?

5) How much to you weigh?

6) How tall are you?

7) Tell me how many total hours you plan to exercise per week?

8) Have you got your doctor's approval for this exercise?

Yes   No

9) Please explain what you plan to achieve with this exercise?

10) What is your email address to send our recommendation to:

11) Finally, what is your name:

12) How serious are you about improving your health and loosing weight?

13) Where are you going to put the treadmill?

14) Do you have limited space and want a folding treadmill?

Yes   No

15) If you want us to call you leave your phone number and time to call:

Phone Number   Time to call: