Relationship, Career & True Love Reading Request

Name *

This is the name we will use on your chart. Your name does not impact the reading in any way.

First Name

Last Name

Phone

This is the number we will use to call you for the consultation (unless we agree to use Skype). Landlines tend to work better than cell phones. If you only have a cell, please do just make sure you have a full charge and are in a good reception zone.

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###

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Preferred Method of Communication for Consultation

Phone Call

Skype

Zoom

Level of Astrological Knowledge

None

Beginner

Intermediate

Advanced

Existing Client

If you are an existing client, we do not need your birth data.

Birth Date

If you prefer not to send your birth data using this form, please just let us know that in the text area below "Birth Time Unknown or Uncertain". You can leave us a voice message with your birth data at 805-409-4605. IMPORTANT: MONTH, DAY, YEAR FORMAT!

MM

DD

YYYY

Birth Time Source

Birth Certificate

Baby Book, Bracelet

Family Memory

Rectification

Other

Name of Second Person

If reading is for more than one person. Note: A True Love Reading is only for 1 person.

First Name

Last Name

Second Person Birth Date

MM

DD

YYYY

Second Person Birth Time Source

Birth Certificate

Baby Book, Bracelet

Family Memory

Rectification

Other