Regulate You Sign Up Name * First Name Last Name Phone (###) ### #### The thing I've enjoyed most about Regulate You is... * The thing that I have not enjoyed or that's been challenging is... I would like to learn more about... I would like to sign up for another month of Regulate You- ( if the answer if YES please fill out your availability) * Yes No thanks Going Forward My Most Available Times Are: ( check all that apply) Mondays late mornings Monday afternoons Monday Evenings Tuesday late mornings Tuesday afternoons Tuesday evenings Wednesday afternoons Wednesday evenings Thursday late mornings Thursday afternoons Thursday evenings Friday afternoons Sunday Evenings Message Would you be willing to reach out to 1 person and ask them to join these next series of sessions? If so, they will receive the $25 discounted price and you will receive some of my products for free! =) Yes! Not at this time Thank you!
