New Client Intake Form

New Client Intake Form

Designed for you to get the most out of your experience.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Birth

MonthDayYear
Date
Exact Time of Birth (include AM or PM)
Place of Birth (Township and Country)
Do you follow any particular religious or spiritual beliefs?

Animism (Indigenous World View)PaganismSufism or MysticismChristianityBuddhismNon religious SpiritualityAtheismOther
If you have any further comments about your spiritual or reglious orientation, please list here
What draws you to getting an astrology reading at this point in your life?
What are your main objectives and desires for working with Luna?

Understanding my karma and healing old wounds/mental patternsClarity and direction moving through a transitional timeWorking on a specific issue (relationships/career/finance)Spiritual growth and personal developmentOther
Which of these clusters of adversary emotions feels the most charged in your lived experience? If there is one particular emotion that stands out or is not listed, click Other.

Longing, envy, desire, obsession, infatuation, anxiety (from not having), restlessness, fear of missing out.Anger, resentment, rage, blame, frustration, contempt, impatience, shame (self-directed hatred), disgust (toward self or others).Numbness, indifference, spaciness, apathy, denial, dissociation, hopelessness, stubbornness (clinging to old views), overwhelm.Other
Which of these clusters of psychological conditions are you most prone towards? If there is one particular condition that stands out or is not listed, click Other.

Addictive patterns (substances, relationships, need for validation), attachment and clinging, perfectionism, materialism and consumerism, people-pleasing for approval, emotional eating or overindulgence, escapism into fantasy or success, overworking or burnout in pursuit of "enough".Judgmentalism, criticism (of self or others), irritation or cynicism, self-hatred or harsh inner critic, emotional reactivity, holding grudges, canceling or ghosting as defense, anxiety masking as control.Disconnection from feelings or reality, willful ignorance, inability to self-reflect, spiritual bypassing, mindless routine or inertia, fantasizing about a “better self” or future, cognitive dissonance, lack of empathy or insight.Other
Have you noticed any recurring patterns or themes in your life that you'd like to get a better understanding of?
Is there any area of your life that has been most problematic or confusing? (e.g., relationships, career, finance, family). What would be your main complaint?
What personal qualities or strengths do you wish to cultivate further? What sort of person do you aspire to become?
What would you say has been your greatest revelation or personal development in your spiritual journey thus far?
Clearly state your core intention for your session in one sentence.
How did you hear about Luna Feyth?
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