FOM Future Ideas

Who are you? *

What's you BEST email address? *

We need to be able to reach your inbox...

What's your BEST number?

Yes, expect a phone call.

How did you hear about Fit Old Man?

How important is your health? *


0	1	2	3	4	5	6	7	8	9	10

Why? *

Why is it important?

How likely are you to commit to and STICK with a comprehensive men's health program? *


0	1	2	3	4	5	6	7	8	9	10

Why now? *

What's kept you stuck? *

Prioritize your limitations...

Accountability

Commitment

Discipline

Strategy

What do you have access to? *

Tell us about your ability to participate. Please select all that apply.

Computer Chrome or Safari Browser Web Cam & Mic iPhone or Android Device Google Drive or Dropbox Account iPhone or Android Device

What kind of Men's Health information do you find MOST useful/valuable? *

Accountability Articles Coaching Events Podcasts Product & Service Reviews (Videos) Webinars

What are some of your favorite Men's Health websites, blogs, podcasts or video channels?

Why?

Specific to Men's Health, what resource do you feel is missing?

Done

Please complete this application to be considered for the next Fit Old Man cohort/group.