Human Design Session Questionnaire

Welcome! I am delighted to meet with you!

Our discovery sessions are produced for the purpose of discussing your goals and identifying the path to success that is uniquely yours. I will recommend the services or programs that may be the most beneficial to support you to achieve the outcomes you desire.

Of course, in our 20-minutes together I will not be providing a Professional Human Design Reading, but I will answer the specific questions you may have about how my work with Human Design can support you to achieve greater success.

Please fill out and submit this questionnaire. A member of our team will contact you within 24 hours on business days to schedule a time for you to speak with Chetan personally to get your questions answered.

Name*

First NameLast Name

Date*

MonthDayYear

Time:*

Indicate AM/PM or 24-hour clock*

AMPM24-hour clock

Birth Place (City and State for US, City and Providence for Canada, City and Country for outside of US)*

Email*

example@example.com

Phone # we should call to reach you at the time of your session (For US and Canada)

Area CodePhone Number

Indicate Landline or cell phone (Landline Preferred)*

LandlineCellphone

For outside the US and Canada... Enter ZOOM in this box. We may request to meet you online in a Zoom session depending on your location.

City*

State*

Country*

Residence Time Zone*

Please let us know how you heard about Human Design For Us All:*

Please let us know who referred you so that we can thank them

1. What is your vision for your life?*

2. What steps have you taken in the past, toward creating your vision?*

3. Is there something you feel is holding you back? And if so, please describe.*

4. Current business or occupation.*

5. Current relationship status.*

6. Education and Professional Training.*

Book a Discovery Session with Chetan

Birth Data

Current Residence

Please give a brief description