ASTROLOGY - INTAKE FORM
ASTROLOGY READINGS & MORE @ B Ruppe's 
Curanderx Community Clinic on 4/29 10AM - 3PM

Share your astrology and questions for KPF to pull up your chart ahead of the event.
No sign up required, walks-ups welcomed but priority will be given to those who RSVP here.

To get the best out of your experience, please fill out this brief questionnaire at your earliest convenience. Ideally, at the time of booking and no later than 15min before our visit.
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PART 1 - About You
Name *
Email *
Same one you used for our appointment.
 Pronouns
Your Birthday *
MM
/
DD
/
YYYY
Birthtime
We use this to cast your natal chart and is important for confirming your rising sign.
Time
:
How accurate is this time?
Please note, although we can pull your chart without a solid time, you will get the best results with an accurate hour and minute; So it's worth searching for it if you can.
What (city / state / country) were you born? *
Used to cast your natal chart.
PART 2 - About our session
Are you in interested in: *
How will we spend the time?
Required
What do you want to get our of this session? *
The more details you provide, the better I can prepare ahead.
Are there any boundaries or triggers you'd like for us to be mindful of?
Only share what you feel comfortable, it can be surface level.
Please read and agree the following
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