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Low GI Weight Loss Protocol 2024 Application

Please fill out and complete the application within the next 2 hours to secure your spot.

Click the button below to start.

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Question 1 of 13

Thank you so much for your interest in working with me in Low GI Weight Loss! 

1. What excites you about potentially working together?
2. Why do you feel my program might be for you?

Question 2 of 13

How did you find Jen and Well + Easy?

Question 3 of 13

Do you have any of the following health conditions?

(Select all that apply)
A

Prediabetes

B

Diabetes

C

PCOS

D

Menopause

E

Perimenopause

F

Insulin Resistance

G

Overweight

H

Other/Additional

Question 4 of 13

If you selected "Other/Additional", can you share more about your health status?

Question 5 of 13

Did your doctor recommend a low glycemic diet to support your weight and health goals?

A

Yes

B

No

C

No, I came to the conclusion after researching

Question 6 of 13

How committed are you to making a change in your life? (only 7 more quick questions left!)

A

Very committed

B

Somewhat committed

C

Not really committed

D

Not committed

Question 7 of 13

Based on your commitment level, what makes this time different?

Question 8 of 13

What is your age range?

A

25-35

B

36-45

C

46-55

D

56-65

E

66-75

F

76-85

G

86-95

Question 9 of 13

What do you hope to gain from working through this program with me? 

(Select all that apply)
A

Knowledge

B

Empowerment

C

Community

D

Support

E

Positive outlook

F

Transformation

Question 10 of 13

What else do you hope to gain? 

Question 11 of 13

If accepted, are you willing to commit 100%?

A

Yes

B

No

Question 12 of 13

Are you willing to provide a video or written testimonial of your experience and results? (this will be used for marketing purposes in the future to share with other women considering joining the program).


Please note: if you're not tech savvy, we'll be able to support you with creating the very short 1-2 minute long video.

A

Yes

B

No

Question 13 of 13

Is there anything else you'd like me to know?

Confirm and Submit