Name

First Name

Last Name

Your preferred name (if different than above):

City where you live.

Best Phone Number

(###)

###

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How did you hear about Judi Isaacson?

Tell me a little about yourself, career, hobbies, role in life:

What are 3-5 reasons/goals of why you want to train with Judi?

What do you hope to achieve from this training?

Please list any physical limitations.

Are there any hesitations, concerns and/or additional things you would like Judi to know about you?