The Summer Shift Application

1

Name

First Name

Last Name

2

Best Email To Reach You?

example@example.com

3

What city do you live in? (I will be hosting an in person event at the end of the challenge)

4

How would you describe your relationship with weight loss right now?

I've been trying for a while and keep ending up back where I started

I know what to do but can't seem to make it stick

I feel like I've tried everything and nothing works for me

I've given up trying and I'm ready to try something completely different

5

Type a question

Calorie counting / MyFitnessPal

Keto, Whole30, or another specific diet

Weight Watchers / Noom / similar program

Working with a personal trainer

A meal delivery or meal prep service

I've tried a little of everything

6

5. What's the biggest thing that tends to derail you?

Stress and emotional eating

All-or-nothing thinking (one bad day = giving up)

My schedule — I just don't have time or energy

Social situations, weekends, or eating out

I start strong but lose motivation after a few weeks

7

6. Why is now the right time for you?

I've hit a point where I'm just done feeling this way

Something specific happened recently that made me want to change

Summer feels like the right moment to finally do this

I've been putting it off too long and I'm ready to stop waiting

8

Can you commit to a weekly 45–60 min call for 8 weeks (June through July)?

Yes, I can make this work

I'd need to discuss the scheduling

Probably not — my schedule is too unpredictable right now

9

Are you comfortable sharing your experience as a testimonial if you get results?

Yes, happy to share my story

Yes, but I'd want to review it before it's used

No, I'd prefer to keep it private

10

Anything else I should know about you?