Hotmomz Application Form

1

Most women are multitasking while doing this. I want you to make a commitment that you will focus on yourself right now so you can fill this out and choose a time to talk so you can finally end the cycle of things not working out. Do you agree to commit to yourself right now?* This field is required.

Yes, because I'm ready to LOSE WEIGHT, balance my hormones, increase confidence, Improve Focus and Get Healthy, HAPPY & Hot AF

No - I am going to leave this page immediately

2

What's Your Biggest Problem Right now?* This field is required.(what's going on right now that's making you feel stuck, confused, frustrated, angry, sad or defeated)

3

Where did you find Casey?* This field is required.

Podcast

Instagram/Facebook

Tiktok/Youtube

4

How long have you been following Casey?* This field is required.

Just found out but i like her ;p

2-3 months

Couple of weeks

1+ years

5

If you could hit all of your health & success goals in record time (guaranteed), through a trauma-informed approach because it clears the reason why you would fail, would you be willing (and able) to invest in getting the necessary help to get there?* This field is required.

Yes, but I do not have access to the financial resources to invest and my household is under 80k

yes, My household income is over 80k and I have the financial freedom and flexibility to personal invest myself.

yes, and I personally make 40K+ a year

6

What concepts, tactics, and mindset strategies, inside the video you saw made you feel that our approach could possibly be the right fit?* This field is required.

7

What is your occupation? (what type of work do you do? This helps us understand your stress levels)* This field is required.

8

If you have a partner, are they supportive of you improving your self-worth which would result in you feeling more confident, successful, sexy, and powerful?* This field is required.

YESNO

9

What's your name?* This field is required.

First Name

Last Name

10

What's your best email?* This field is required.

example@example.com

Confirm Email

11

What's your phone number? (for the call)* This field is required.Please enter in this format: 555-666-7777

12

You're almost done! Please click submit to send your application.