First Name *

Last Name *

Email *

How long have you been living with T1D? *

Roughly what is your TIR? *

What are you using to manage blood sugar levels? *

Pump

Injections

What’s been going on with your management that made you want to apply for a strategy call? *

What feels most frustrating or confusing about your blood sugars right now? *

What have you already tried to fix this? *

If nothing changes, how does this affect your life 6–12 months from now? *

How long has this been an issue for you? *

Less than 6 months

6–12 months

Longer

When do problems usually show up? *

After meals

Overnight

Random / inconsistent

A mix

If we determine this is a good fit, are you willing to put in the time and effort required? *

Yes

Possibly

No

If we decide to work together, are you in a position to invest financially in coaching? *

Yes — I’m ready to invest if it makes sense

Possibly — I’d need more clarity

No — I’m not in a position to invest right now

This short application helps me understand your situation and decide if a 1-on-1 strategy call would actually be helpful for you.

Please answer honestly. There’s no pressure and no obligation.