Human Design Roadmap Order Form
Thank You for choosing to purchase your personalized roadmap.

Please use the form below to submit your information for your order. Payment by credit card or e-transfer is required.

You will receive a PDF of your roadmap by email within 48 - 72 hours of submission or sooner.

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Email *
Please Choose Your Roadmap *
Your Name *
Contact Phone Number *
What is the best way for me to communicate with you? Ex. text msg. email etc. Please share your preference below. *
Birth Information
Birth information is an important part of creating your chart. Please double check your information before submitting. Thank you!
What is your birth date and time? *
Please enter the time of your birth (include hour and exact minute. Example: 6:53). Birth time is very important in calculating your chart. If you don't know your birth time, please share your middle name and your maiden name if applicable in the comment section below.
MM
/
DD
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YYYY
Time
:
What country were you born in? *
What city were you born in? *
Do I have your permission to add you to my email newsletter which I send out 1 - 2 times per month? *
Comments / Questions
Payment Instructions
After clicking submit you will be redirected to a confirmation page, click the link to provide your credit card information.

If you would prefer to send an e-transfer, click submit and then you can bypass the credit card payment prompts by closing the payment window, then send an e-transfer to ross@rosstayler.com **please note tayler is spelled with "er". No password is required for the e-transfer as it is set up for auto deposit.

Your order will not be processed until payment is received.

Thank You
A copy of your responses will be emailed to the address you provided.
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