Name * First Name Last Name Email * Preferred Contact * (###) ### #### Reason for our Session * A few key words or a sentence that describe your call to join this session If this session could hit the nail on the head, leaving you feeling sure and empowered - what problem would it have solved? Please select date of birth * For potential Astrology or Human Design reference MM DD YYYY Time of Birth This needs to be as close to exact as possible. Please double check if able. If you do not know your time of birth leave this field blank, we may not be able to use this resource. Hour Minute Second AM PM Location of Birth * If I were to record only myself during this session (to capture valuable insights and post online as a free resource) is this something you would feel comfortable with? * No personal details or circumstances will be included. Yes I am comfortable with this No I am not comfortable with this Is there anything else you would like me to know before meeting? * Thank you!