Application for Time To Deflate's Pre-op 1 Month Intensive

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Email *

Full name *

Preferred phone number *

Are you currently in a pre-op program for weight loss surgery? *

Yes

I am waiting for my first appointment

If yes, do you have a surgery date (or idea for when surgery will be?) *

What are you most nervous about as you near surgery? *

What are you most excited about? *

Have you in the past, or are you currently, seeing a mental health professional? Do you plan to see someone during your pre-op/post-op process? *

What areas are you hoping for more help in, in regards to your health and surgery? *

Understanding nutrition

Understanding exercise

Handling social situations

Talking to loved ones about my weight

Understanding the "why" behind all of these rules from my program

General accountability

Figuring out how to fit this new life with what my family needs

Working on getting more comfortable about sharing things about my weight, food, etc.

Other:

Required

This is a one-month intensive, working directly with me. This program will include a physical welcome gift from Ness Planners (a $50 value!), weekly videos, email contact with me with homework and journal prompts, and weekly 45-minute phone calls with me to go over your personal program and needs. The total cost for this program is $549. Is this a program you are interested in learning more about? *

Heck yes - I'm in and excited!

Maybe - this is going to be a stretch for me.

Nope - I can't afford that. I'll keep watching your content on IG, Youtube, and your blog!

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