LEVLUP
CONGRATULATIONS ON TAKING THE FIRST STEP! The purpose of this form is to help us get to know you better to be sure that you're a great fit for our program. Once you finish, we will be in contact. It should take no longer than 2-3 minutes, so let's get started!
To confirm, you are filling this out because you're sick of the BS and ready to experience REAL change that lasts forever?
Yes, I am so ready to change my life!
No, I will go ahead and leave now.
Great! Let's do this! What's Your First Name & Last Name
First Name
Last Name
What is Your Preferred Email Address?
example@example.com
Phone Number
Instagram Handle
Gender
Male
Female
We have different levels at LevlUp, which level aligns with the goal you are looking to achieve?
Please Select
Weight Loss
Personal Development/Mindset
Relationships
Awesome, If you selected weight loss, which of the following best describes your goal? (if it is another level, please select 'other')
Lose 10+ lbs and regain my confidence and energy to feel great again
Lose weight and improve my relationship with food
Improve hormonal health and quality of life
Add some shape, I want to build muscle and limit fat gain
My MINDSET NEEDS WORK!
Restore my metabolism and understand why past attempts have failed
Other
How did you hear about us?
I've followed and witnessed the amazing success stories of 800+ lives transformed!
I've followed the podcast and love Kait's philosophy!
I know someone you have worked with and feel you're the best fit
I like that Kait has two masters degrees and published research in the field.
I stumbled upon her through social media!
An Ad brought me here!
What do you do for work? (sedentary job, active job, tell us about your role)
If this program is what you are looking for and you feel it is the solution to your problem, are you prepared to invest in yourself?
Please Select
Yes, I am committed to making this change!
No, I will talk myself out of it...
What do you feel is the biggest struggle when it comes to achieving your goals? (knowledge, time, stress, accountability, mindset, etc)
Do you have a significant other? If so, are they supportive of you investing in your weight loss, health, and personal growth?
Yes, they're incredible and so supportive!
Yes, I have a significant other but it's my decision to make
Yes, they may need to be on the call to make a joint decision
No, I am single and make my own rules :)
If your partner needs to be preset, what is their name and contact information?
What is your height, weight, and DOB?
Do you have any experience working with an online coach? If so, please elaborate so I can get an ideas of what you are looking for to make sure we are a good fit.
What are the consequences of you NOT making any changes? How will not doing anything about this impact you long term?
If your desired goals and results from this program were guaranteed and permanent, what would you be willing to invest to become the happiest and healthiest version of yourself?
Please Select
I don't want to invest in myself
Up to $100 per week
$150-200 per week
Whatever it Takes!
I understand this program is not about quick fixes or surface level solutions and I am ready to commit to long term changes.
I understand
I understand that I am applying to the team & will be paired with the coach that best fits my needs! Our coaching staff is ready to assist and take your fitness journey to the next level.
I understand
I understand this program is not about quick fixes or surface level solutions and I am ready to commit to long term changes.
I understand that I am applying to the team & will be paired with the coach that best fits my needs! Our coaching staff is ready to assist and take your fitness journey to the next level.
Anything else that is important for us to know?
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