Intake Form
Please fill out this form as thoroughly as possible and submit it at least 24 hours before your appointment.

This is the first step in a multi-stage process. Based on this information and our initial conversation, I will analyze your charts and send you a recording. Once you have reviewed this recording, we will schedule a followup question-and-answer session in which we can go into even greater depth.

Thank you for investing your precious attention, time and money into this enhancement of your self-awareness.
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Email *
First Name *
Last Name *
Current Location *
Date of Birth *
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Time of Birth (as accurate as possible) *
Time
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Location of Birth *
What area(s) of life are you most interested in exploring? (Check all that apply) *
Required
What is inspiring you to seek astrological guidance? Why now? *
If you could ask only one question, what would it be? *
Have you had your Vedic chart read before? *
What sort of remedies would you be willing to try? *
Required
Is there anyone else that you would like to include in this process? If so, please tell me something about them, describe why they are relevant to your situation, and confirm that we have explicit permission to examine their chart.
Extra Person’s Birth Date
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DD
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Extra Person’s Birth Time
Time
:
Extra Person’s Birth Place (City/Town, State/Region, Country)
How did you find me? *
Is there anything you want me to know before we meet?
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