Please complete this form in its entirety as all information is relevant to your reading.
Contact info: It is helpful to have various ways to communicate with each other, please provide mailing address, email, skype and phone number
Astrological Info- The astrological  information  allows me to create a birth or natal chart which is the lens thru which I enter every assessment or reading.
Photo- Attaching a picture , is for me, the same as having you present in my office. Essentially you are sending me your unique energetic imprint that is contained in the photograph. No sun glasses please…..the eyes truly are the window to the soul !

 










 







 

*** Please provide an EXACT time of birth (birth certificate / baby book)

*** Please provide an EXACT place of birth (birth certificate)


 

 





 
*** 5MB Filesize Limit

 

(This information is invaluable to me for my marketing, thank you!!)

 
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