Undiet You

Application Form

If you are interested in working with Lizzie in a group or 1:1 setting, please fill out this application form:

First Name *

Last Name *

Phone *

Email *

Where are you located (City, State) *

How did you hear about Lizzie / Undiet You (IG, TikTik, Podcast, Referral etc)

How long have you been experiencing these issues?

What have you tried in the past that hasn’t worked?

What would your life look like if you did feel amazing again?

Have you had bloodwork done within the last 3 months?

Yes

No

I don't know

If yes, briefly describe what kind (thyroid panel, hormone test, gut test, etc.) and what you were told.

Why are you applying for 1:1 coaching with Lizzie right now?

On a scale of 1-10, how ready are you to invest time, energy, and financial resources into healing? (1= not ready to commit yet, 10 = ready to invest and start right now) *

This is a high-touch, high-transformation program designed for deep healing and personalized support. The investment reflects that. Are you in a place financially to invest in your health if this is a good fit?

Yes, I am ready and committed to invest in a higher level program.(Financing options available)

I'm open and would love to learn more

If accepted, when would you want to start?

ASAP

Within 2 weeks

Within the next month

If one-on-one coaching is not a good fit for you, are you open to exploring other options such as group coaching?

Is there anything else you would like me to know?

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

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