Client Intake Form

Client Intake Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Please enter a valid phone number.
Email
example@example.com
Birth Date

MonthDayYear
Date
What question(s) would you like to focus on for this reading today?
What is your current situation?
What is your desired outcome?
What actions have you tried.
What experience have you had with the Tarot before today?
What is your stance on how Tarot work?
What would make this a highly valuable session for you?
Is there anything else you would like me to know?
(New Client) What inspired you to request a reading with me?
I have read Client agreement, Ethic and Liabilites

Yes
Signature
Today's Date

MonthDayYear
Date
Should be Empty: