Client Divination Form

Client Name*

First NameLast Name

Birth Date*

MonthDayYear

Birth Place*

Street Address

Street Address Line 2

CityState

Other Countries

Birth Time

If unknown, please get as accurate as possible. This greatly impacts astrology charts/integration for all readings. Please clarify AM or PM.

Email*

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Phone Number*

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Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How did you hear about us?*

Website / Online SearchSocial MediaReferralOther

Types of Readings (pick one)*

General - Great for general inquiries and advice. No specific question is needed. Remain receptive & open and the messages will reveal themselves.Relationship - Good for intimate, platonic, or family relationships involving you and the other person. Can be done solo or with both people present.Inner Landscape - Gives you insight on your higher self, your shadow self and how you integrate those aspects through all your relationships.Cosmic Connections - Allows you to deepen your conscious connection to your unique spiritual gifts & celestial guides.Crossroads -Perfect for when you feel stuck, uncertain, anxious or insecure about the next steps to take on your path.

If there is any other information or details you'd like to add please do so below.

If you selected a Relationship Reading & if you would like to add any details, please do so below. You may include birthdays/time/place of other people involved.

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Disclosure Statement: A tarot professional cannot predict the future with certainty and you should not rely on a tarot reading to make any decision that would affect your legal, financial, or medical condition. If your inquiry involves the law, finance, or medicine, then you should seek the advice of a licensed or qualified legal, financial, or medical professional. Also, tarot reading cannot replace qualified mental health care. A tarot reading can only facilitate how you cope spiritually with a given situation. In certain jurisdictions, a tarot professional is required to disclose to you that tarot readings should be for entertainment purposes only, and if such a law applies to your reading, then you are hereby on notice thereof. Your tarot professional is bound by a self-imposed code of ethics, which can be provided to you upon request.

We will never share your personal information. Please visit our website Privacy Policy page for more information.

Signature*

Date*

Date

Deposit for Reading

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Divination Deposit PaymentDeposit is half of 1 hour Tarot/Oracle/Astrology Readings prior to your appmt. If you need to reschedule please give us a 48 hr notice. This deposit can be used for your rescheduled appmt.Cancelations made after 48 hrs before your appmt are non-refundable.

$40.00

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