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Client Intake Form

Please complete the below questions - these are needed to do a thorough astrology reading. By booking this consultation, you acknowledge that services are intended for personal insight and educational purposes only, and do not replace licensed professional advice.

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1.  Your exact time of birth, date of birth and place of birth

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2. Current marital status (add wedding date(s) if available)

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3. Whether you have kids and when they were born (month + year is fine)

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4. If your parents are alive

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5. If you have brothers / sisters (indicate if older / younger)

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6. If you have any chronic / serious diseases (please list)

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7. Education (area) and current occupation

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8. Dates of any significant personal life events (month + year is fine)

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9. What your possible questions are (relationships, finances and career, kids, relocation or travel, health, etc.)

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I confirm that my provided birth data is accurate and I understand the consultation disclaimer.  I agree with Terms & Conditions of this service published on the website. 
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1.  Your exact time of birth, date of birth and place of birth

No responses yet for this question.

2. Current marital status (add wedding date(s) if available)

No responses yet for this question.

3. Whether you have kids and when they were born (month + year is fine)

No responses yet for this question.

4. If your parents are alive

No responses yet for this question.

5. If you have brothers / sisters (indicate if older / younger)

No responses yet for this question.

6. If you have any chronic / serious diseases (please list)

No responses yet for this question.

7. Education (area) and current occupation

No responses yet for this question.

8. Dates of any significant personal life events (month + year is fine)

No responses yet for this question.

9. What your possible questions are (relationships, finances and career, kids, relocation or travel, health, etc.)

No responses yet for this question.
I confirm that my provided birth data is accurate and I understand the consultation disclaimer.  I agree with Terms & Conditions of this service published on the website. 
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