Human Design Session Questionnaire

Discovery Session Request

Advanced Relationship Training / Karma Clearing
Name*

First NameLast Name
Email*
example@example.com
Birth Data
Date*

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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)*
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.
Current Residence
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Residence Time Zone*
Please let us know how you heard about Evolutionary Human Design :*

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Please let us know who referred you so that we can thank them
Current knowledge of Human Design*

Just introduced – I’m new to HD!Have my HD Report & desire to learn moreHave read HD BookHave taken HD Training previously
If you have previously taken human design training, which one did you take?*

Level One onlyLevel TwoLevel ThreeProfessional Human Design ConsultantNo Human Design TrainingOther
Let us know if you are inquiring about one or both of our Live Events*

Advanced Relationship Training onlyKarma Clearing Training onlyBoth Trainings
Briefly describe questions have regarding either training
In order to be prepared for our Advanced Relationship Training you need to have a full understanding of, and can work with, standard Human Design Relationship dynamics.

Relationship Dynamics are taught in Human Design Level 3 courses.
Are you familiar with Human Design Relationship Dynamics?

YesNoCurrently Studying
If you have completed Level 3 - Human Design Training, please tell us who you studied with

Carola & Chetan- Evolutionary Human DesignSomeone elseOther
If someone else, let us know who.
Do you have any other information that you want us to know about why you are considering these training programs?
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Discovery Session Request

Birth Data

Current Residence