VIP Day Application (Intake) Form
Welcome! Thank you for your interest in working together, I'm really looking forward to reading your application and working with you. The answers you provide on this form not only help me determine if you're a good fit for the VIP day but also will allow me to best prepare for our session once confirmed and in the diary. 

Completing the form will take anywhere between 5-20 minutes. Some will really get in there and write their hearts out, some like to ease in and just give me the headline, the need to knows. Please know, you can skip questions you don't feel comfortable answering. And if there are questions you're unsure about, it is more than okay to say "I'm not sure yet." Feel free to also put "I'd like support around this".

If you have any questions or need any support, please send an email to
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Email *
Name *
I am a... *
Tell me about you and your business. What do you do and where is your business at right now? *Private coaching with me is £2500 for 3 months
What are your most important professional (and personal goals if relevant) for the next 6 months?  *
Please share with me your key social media & website and any other links you feel relevant to your work so I can get a good understanding of your business presence.  *
What would be a powerful outcome for you from our VIP Day together? 
Would you like In-Person or Virtual? *
Please let me know which location & date you would like to have the VIP day. All the available options are listed below (you can select more than 1 if you are flexible)> January & February Dates & Location will be announced soon but select below to express interest for the new year.  *
On the day and afterwards with resources, I am willing to be guided through relaxation, visual imagery, creative visualization, hypnosis, and stress reduction processes and techniques for the purpose of self-improvement. I understand that any meditations or Mindset Techniques I am participating in is not a substitute for medical care and I have been advised to discuss anything I partake in with any doctor who is taking care of me now or in the future. Additionally, I should continue any present medical treatment and consult my regular medical doctor for treatment of any new or old illnesses.
A copy of your responses will be emailed to the address you provided.
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