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Submission Form 1: Beginning of the Weight Loss Journey
1
Name (First and Last)
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2
E-mail so we can get in touch
*
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Our marketing and PR team will reach out directly if there's an opportunity to showcase your story.
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3
Age
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4
City, State, Country
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5
What's your Occupation?
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6
We'd love to hear about your weight loss goals!
*
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Please give us your weight when you started using Lose It!, your current weight, and your goal weight.
Starting Weight
Current Weight
Goal Weight
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7
If you have an instagram account, please provide a link to your profile.
This will be used to tag you if we decide to share your story on our social media channels!
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8
Which weight loss plan are you on?
*
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Lose 1/2 pound per week
Lose 1 pound per week
Lose 1.5 pound per week
Lose 2 pounds per week
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9
Tell us about why you decided to start losing weight
*
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Whether it's a big life event, a doctor recommendation, or something else - we want to hear about what motivated you to focus on reaching a healthy weight. 2-3 sentences is great - or more if you’d like!
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10
What is one of the biggest things you’ve learned since starting your weight loss journey?
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2-3 sentences is great. Take all the space you need.
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11
Photo 1
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12
Photo 2
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13
Photo 3 (Optional)
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14
Authorization
I hereby authorize Lose It! and its parent Company FitNow, Inc. (“Lose It!”) to use my submitted testimonial content (including any pictures, my name and physical health information), in whole or in part, to advertise and promote Lose It! in social, digital or printed publications, newsletters, multi-media presentations or any other media now known or hereafter developed. I waive any claims that I or my heirs, representatives, or any other persons acting on my behalf or on behalf of my estate may have by reason of this authorization
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I authorize Lose It! to use my content provided in this form.
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