LIFT Program application

Parent's name and email

How old is your teen?

What is the name of your teen?

What is your teen's gender?

What's your teen's biggest health concern right now?

Weight gain or trouble losing weight

Prediabetes or insulin resistancee

PCOS or irregular periods

Fatigue, low energy, or mood changes

Family history of diabetes (prevention focus)

Disordered eating patterns or food struggles

Other (please describe below).

What have you already tried and what made those things not work, in your opinion?

What would success look like at the end of 100 days?

Have you talked to your teen about joining this program?

The 100-day LIFT Program is a paid coaching program. It's not covered by insurance, though it may be reimbursable through your FSA or HSA depending on your specific plan.

We'll cover program details and pricing on our call. By the end of it, I want you deciding based on one thing only: whether you believe this is the right path for your teen. The rest, we will figure out together.

But here's the honest truth: this program won't deliver results if your family isn't ready to commit to real changes in daily habits.

On a scale of 1–10, how committed is your family to going all in for the next 100 days?

How did you hear about this program?

Dr. Jenny accepts a very limited number of private 1:1 clients for wellness coaching. Would you like to be considered?

I understand the LIFT Program is a paid private coaching program, is not covered by insurance, and FSA/HSA reimbursement is not guaranteed. I'm comfortable discussing pricing and payment plans on our call

I understand that while Dr. Gourgari has a license as a pediatric endocrinologist, she is not providing health care, medical, psychological, or nutritional therapy services or attempting to diagnose, treat, prevent, or cure any physical, mental, or emotional issue, disease, or condition through the information shared on or through this program. I understand I will always consult with my own medical or mental health provider before making any changes to my child's care. By checking this box, I confirm I am 18 years or older and I agree to the Privacy Policy, Disclaimer and Terms of Use.

SUBMIT

LIFT Program Application