GLP-1 Optimized Application Form

Basic Information

First Name *

Last Name *

Phone *

Email *

Medication + GLP-1 Use

Are you currently using a GLP-1 receptor agonist (e.g., semaglutide, tirzepatide)? *

Yes

No

I used it in the past

I will, but I haven't started yet

How long have you been using GLP-1? *

When would you like to begin tapering off the medication? *

Are you prepared to invest $1k+ per month on personalized 1-on-1 coaching if it’s the right fit?

Would you be willing to follow a structured plan and check-in weekly?

What’s your why for doing this program? *

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.

TERMS OF USE | PRIVACY POLICY

MEET your coach

Hey, I'm Jake!

GLP-1 Specialist | Nutrition Coach | Certified Personal Trainer

I’m the coach behind GLP-1 Optimized, a program built to solve the problems most people face on GLP-1s.

Rapid weight loss without a plan can lead to muscle loss, a slowed metabolism, and long-term health issues. I help high-achievers do it differently. With the right training, nutrition, and habit strategy, you can lose fat while staying strong, healthy, and in control. Taking a GLP-1 isn’t the easy way out if you do it the right way. This is a smart and structured approach. That’s what this program delivers.

Have questions?

Email me at [email protected]. I'm happy to help.

Want expert tips, free resources, and exclusive GLP-1 coaching insights straight to your inbox?

MEET your coach

Hey, I'm Jake!

GLP-1 Specialist | Nutrition Coach | ​Certified Personal Trainer

Have questions?

Want expert tips, free resources, and exclusive GLP-1 coaching insights straight to your inbox?

GLP-1 Specialist | Nutrition Coach | Certified Personal Trainer