New Customer Registration Form

Customer Details:

Please fill out the form below and we will follow up with practitioner's availability.
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Who do you want to see?*
What are you interested in seeing them for?*
Please include availability (with at least one 1st choice and 2nd choice date & times): *
What you intend to pay on sliding scale:*
For Astrology only, include your exact time and place of birth:
How did you hear about us?
Please Read:*

By checking this box I understand it does not book a session but begins the process. We will reach out to you within 48-72 hours of your inquiry. We require a 48 hour cancellation notice to reschedule your session. If you cancel within the 48 hour window you will be charged.

My Products

Choose Your Sessions

If you qualify for sliding scale, we will adjust/refund the difference upon appointment confirmation.

$100.00

Item subtotal:$0.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Customer Details: