Share My Lose It! Story

1

Name (First and Last)* This field is required.

2

E-mail so we can get in touch* This field is required.Our marketing and PR team will reach out directly if there's an opportunity to showcase your story.

3

Age* This field is required.

4

City, State, Country* This field is required.

5

What's your Occupation?

6

We'd love to hear about your weight loss goals!* This field is required.Please give us your weight when you started using Lose It!, your current weight, and your goal weight.

Starting Weight

Current Weight

Goal Weight

7

If you have an instagram account, please provide a link to your profile. This will be used to tag you if we decide to share your story on our social media channels!

8

Which weight loss plan are you on?* This field is required.

Lose 1/2 pound per week

Lose 1 pound per week

Lose 1.5 pound per week

Lose 2 pounds per week

9

Tell us about why you decided to start losing weight * This field is required.Whether it's a big life event, a doctor recommendation, or something else - we want to hear about what motivated you to focus on reaching a healthy weight. 2-3 sentences is great - or more if you’d like!

10

What is one of the biggest things you’ve learned since starting your weight loss journey? * This field is required.2-3 sentences is great. Take all the space you need.

11

Photo 1* This field is required.

Drag and drop files here

Select files to upload

12

Photo 2* This field is required.

Drag and drop files here

Select files to upload

13

Photo 3 (Optional)

Drag and drop files here

Select files to upload

14

I hereby authorize Lose It! and its parent Company FitNow, Inc. (“Lose It!”) to use my submitted testimonial content (including any pictures, my name and biographical information), in whole or in part, to advertise and promote Lose It! in social, digital or printed publications, newsletters, multi-media presentations or any other media now known or hereafter developed. I waive any claims that I or my heirs, representatives, or any other persons acting on my behalf or on behalf of my estate may have by reason of this authorization.

15

Authorization

I authorize Lose It! to use my content provided in this form.