LIFT1
Full `name:
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Age :
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Gender :
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Mobile number (please include country code):
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Email:
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Preferred contact method:
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Instagram handle:
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Where are you based? Please indicate your timezone:
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How experienced and comfortable are you in the gym?:
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Current diet and eating habits:
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What is your average time in range across 7 days?:
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What was your recent A1C (in the last 2 months), or your EA1C according to CGM:
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How do you feel about your diabetes management currently?:
How frequently do you drink alcohol :
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Do you smoke:
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Your number 1 diabetes goal:
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Your number 1 fitness goal:
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How high up are these on your list of priorities?:
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How much are you able to financially commit to per month:
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150-200 GBP
200 - 250 GBP
250 + GBP
How did you hear about me?:
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