Which membership service is this about?

Initial Coaching Program(3 month contract)

Core Coaching Program (6 month contract)

Longevity Coaching Program(1 year contract)

Nutrition Program

How well has the Coaching Staff attended to your fitness goals and needs?

Excellent

Pretty Good

Just Okay

Needs Some Work

Overall, how would you rate your experience at Regenerate Health & Fitness?

Excellent

Pretty Good

Just Okay

Needs Some Work

How likely are you to recommend our gym to others?

Very Likely

Maybe

Not Sure

Definitly Not

Comments - Share any other feedback you would like to give us...

Please describe the reason for your cancellation or hold request.

Do you wish to hold or cancel your membership?

Hold My Membership

I Need to Cancel

If holding, enter your hold start and return dates below

Hold Start Date (if holding)

Hold End Date

I agree to the terms of the membership hold policy

I agree to the terms of the membership cancellation policy

I agree to terms & conditions of the membership hold/cancellation policy