Metabolic Health Initiative Application- Julia and Rob

Metabolic Health Initiative: Participant Application

Real women. Real results. Real science.
Thank you for your interest in the Metabolic Health Initiative — a 30-day participant-based project designed to gather real-life results that mirror existing clinical research.

This program focuses on improving metabolic function and addressing key factors like insulin resistance, Type 2 diabetes, high blood pressure, and high cholesterol.

We’re currently reviewing applications for our next participant group. Please complete the short form below so we can determine if this opportunity is the right fit for you.
Full Name*

First NameLast Name
Age*
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
City / State*
What are your top 2–3 health goals right now? (e.g., Fat loss, Energy, Hormonal balance, Metabolic reset, Better eating habits)*
Do you currently have any diagnosed metabolic conditions (High cholesterol, High blood pressure, Insulin resistance, Type 2 diabetes, etc.)?*

YesNo
If yes, please specify below.
On a scale of 1–10, how consistent are your nutrition and hydration habits right now? (1 = very inconsistent, 10 = very consistent)*

1

2

3

4

5

6

7

8

9

10

1 is 1 (Very inconsistent), 10 is 10 (Very consistent)
How many hours a day do you typically spend on your feet or moving?*
What does a typical day of eating look like for you?*
What has been your biggest challenge with weight loss or energy in the past?*
Why do you want to be part of this initiative? (Short answer — what’s motivating you right now?)*
Are you willing to:*

Track your data using the provided scaleSubmit weekly progress check-insShare your final results and short reflection at the end of 30 days
If selected, are you available for a short 10-minute phone call this week to review details and confirm participation?*

Yes, please contact me to scheduleNot this week, but I’m interested in the next group
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Metabolic Health Initiative: Participant Application