List ALL Supplements & Medications currently on or type none *
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Check all that apply to your health: *
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List any other medical diagnoses, concerns, complications, issues not covered above
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Tell us your story! What is motivating you now? What are your goals both with weight and lifestyle? What do you want to do or experience once you lose weight? *
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Do you get any regular physical activity? If yes, explain what you like to do. *
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How did you find out about this AWESOME opportunity? (If a person referred you please list their name) *
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Anything else you would like to share so we can get to know you better?
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Any travel or off limit dates January - early April 2022?
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Will you be able to email Hello@BrianaMichel.com the REQUIRED photos in appropriate attire within 48 hours of submitting? (See casting page again for photo requirements for clothing and posing) *