1-1 Coaching and Mentorship Booking Form

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Thank you for submitting your interest in our 1-1 Lessons. Please allow 1-2 working days for a response. Hannah-Rose will have to check studio availability before confirming your session.

Name

Feel free to share your pronouns

*Put a full stop in the box above to proceed with the form if you prefer not to share your pronouns.

Would you prefer us to work online via video call, or in person?

Online

In Person

Either/both

Please note I have a lot more availability via video call, and in person sessions take place in Brighton, UK only

Price information

£65 (Full Price) per 50-minute session

£60 (Standard) – Per 50-minute session

£55 (Concession) – per 50 minute session

* Funded sessions not yet available but hopefully on their way next year or soon: me and my little team are exploring funding options to improve access to this work.

Please choose your price (required)

Full price Standard Concession

Kindly indicate your preferred day/time for a one-on-one session below.

Weekday daytimes: Tuesday – Friday (Please specify your preference)

Weekday early evenings: Tuesday – Friday (Please specify your preference)

If you are hoping for a specific date/time please state below.

Let me know as much as you’re happy to, about the below. Your answers will be kept confidential.

What are your top 3 goals you’d like to achieve through coaching? (Please be as specific as possible)

On a scale of 1-10, how satisfied are you currently with the areas you’re seeking coaching for, and why? (1 being unsatisfied and 10 being satisfied)

What previous strategies have you tried to achieve these goals, and what were the results?

What potential obstacles or challenges do you anticipate in reaching your goals?

What does success look like for you by the end of our coaching relationship?

Let me know about any accessibility requirements you have.

Confidentiality Statement

All information provided in this intake form and during our coaching relationship will be kept strictly confidential. Your personal data and responses will only be accessible to your coach and will not be shared with any third parties without your explicit written consent, except in situations where there is a legal obligation to report (such as risk of harm to self or others).

Your privacy is respected and protected throughout our coaching engagement. Any notes taken during our sessions are stored securely and used solely for the purpose of supporting your coaching journey. You have the right to request access to your information or ask for it to be deleted at any time.

By completing this form, you acknowledge that you understand and agree to these confidentiality terms.

Please review and submit your response to our Cancellation Policy

Please review and submit your response to our Infection Safety Policy