Enquiry Form

Hello and welcome!

This form is your first step towards working together.

It helps me understand who you are, what you’re working towards, and whether we’re a good fit. I read every enquiry personally and will be in touch within 2–3 working days.

If you’re ready for clarity, structure and support in your training - you’re in the right place.

Regina x

What is your name?*

What is your email address?*

What is your phone number?*

What is your Instagram handle? (if you have one)*

What is your age?*

Where did you hear from me?*

What prompted you to reach out right now?*

What would you like to work on together?*

Why is this important to you at this stage of your life?*

If nothing changes, how will you feel in 6 months?*

What do you feel is currently holding you back?*

Have you tried to work towards this goal before? If so, what happened?*

On a scale of 1–10, how committed are you to making a change right now?

What would make that number higher?*

Why do you feel I might be the right coach for you?*

Face-to-face sessionsOnline CoachingHybrid (face-to-face and online)Not sure yet

Yes, I am ready to startI’m interested but would like more informationNot at the moment

If you're interested in face-to-face sessions, please share your general availability (days/times) and how many sessions per week you would ideally like.*