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Client Intake Form
Complete this form before your session. Birth data must be as accurate as possible. Your chart depends on it. All information is kept strictly confidential.
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Contact
Name
✴
Current Location
✴
i
Your present city and country. Used to calculate transits to where you are living now, which may differ from your birth location.
Email Address
✴
Pronouns
New or Returning Client?
✴
New client
Returning client
Birth Data
Date of Birth
✴
Time of Birth
✴
i
Your birth time determines your rising sign and all house placements. If you are unsure, enter your best estimate and select the appropriate rating below. Use 12:00 if completely unknown.
Birth Time Rating
✴
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AA
Birth certificate or official hospital record
A
Quoted by family or from personal memory
B
From biography, autobiography, or news report
C
Speculative, rectified, or unverified source
DD
Conflicting data from multiple unverified sources
X
No birth time recorded
XX
Time known to be incorrect or withheld
select one
AA: Birth certificate or official hospital record
A: Quoted by family or from personal memory
B: From biography, autobiography, or news report
C: Speculative, rectified, or unverified source
DD: Conflicting data from multiple unverified sources
X: No birth time recorded
XX: Time known to be incorrect or withheld
City of Birth
✴
State / Province
Country
✴
Your Reading
Reading Type
✴
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Current Conditions
A look at where things stand right now. Your Sun, Moon, and Rising, then the planets and houses tied to what you bring in. Not a full chart reading, a targeted one.
Weather Report
Everything in Current Conditions, plus a Forecast Window: the next major moment coming up in your chart (solar return, Saturn return, profection lord, etc). Also the right pick if your question touches a job offer, a launch, a big event, or timing a decision.
Full Forecast
A full read of your chart from the ground up. Every planet, sign, and house, the aspects between them, then transits and Forecast Windows.
Move-Out Special
Astrological conditions, problem-solving, and a vent session that ends in actionable steps to get you out. Especially resonant during a Saturn return.
Roommate Synastry
A synastry reading built for roommates, not romance. Where you naturally sync up, where friction is likely, and how to actually live together well. Requires both people's birth data. Can be split two ways.
School Year Reading
A chart cast for the moment your first class starts, read against your natal chart: where you'll thrive, where you'll need to watch yourself, and what this school year is asking of you.
Current Conditions
· 30 min
$85
Weather Report
Most Popular
· 60 min
$160
Full Forecast
· 90 min
$245
Specials
This Month: Move-Out Special
· 60 min
$185
Roommate Synastry
· 60 min
$170
School Year Reading
· 45 min
$135
This Month's Special
Anything Specific About Your Situation?
Optional, but helpful context for this month's themed reading.
Your Roommate's Birth Data
$170 total for the session covering you and one additional roommate. A common way to split it is $85 each. Right now booking only charges one card, so whoever books pays the full amount at checkout and settles up with their roommate(s) directly (Venmo, Cash App, cash, whatever's easiest).
With more than one additional roommate, I'll confirm final pricing with you directly based on group size before we lock in a time.
Roommate's Name
Roommate's Date of Birth
Roommate's Time of Birth
Use 12:00 if unknown.
Roommate's City of Birth
Roommate's State / Province
Roommate's Country
+ Add Another Roommate
Hey, Brockhampton, you're going to have to email me if you are living in a hostel situation or something.
About Your School Year
The chart for this reading is cast for the moment your first class starts. That's the chart that opens the whole school year, the same way a birthday chart opens a solar return.
Date of First Class
✴
Time of First Class
✴
School Location
✴
City and state/country of the school, or wherever that first class actually meets.
School Name
Optional.
Major / Field of Study
Optional.
Graduation Year
Optional.
Anything Else to Flag?
Year/level, program details, or anything specific you want looked at. Optional.
What's Bringing You Here?
✴
Describe where you are right now: what's active, pressing, or in transition. The more context you give, the more useful your session will be.
Specific Questions or Topics
i
Add your questions one at a time and tag each with the area of life it relates to. If it's not an exact match - it's not the end of the world. Order them by priority. I work through them in sequence and may not reach every question in a single session.
Not required, but helpful. Add in order of importance.
No questions added yet. Use the button below to add one.
+ Add question
Add-Ons
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Optional additions you can include with any reading. Toggle to add. Each one that requires extra information will expand a text area below it. Prices are in addition to your session fee.
Session Summary
$25
i
Typed overview of key themes, patterns, and action steps from your reading, delivered alongside your recording.
Relocation / Astrocartography Experimentation
$25
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A first look at your relocation lines, added onto any session. This is exploratory, not a full professional relocation analysis. I'm actively building this skill and pricing it accordingly.
Synastry
$85/person
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Bring in 1 or 2 additional people's charts and I'll read how they interact with yours. $85 per person, 45 extra minutes per person added to your session. Max 2 additional charts.
How Many Additional Charts?
1 additional person, $85, +45 min
2 additional people, $170, +90 min
Additional Person 1
Name
Date of Birth
Time of Birth
Use 12:00 if unknown.
Birth Time Rating
select one
AA: Birth certificate or official hospital record
A: Quoted by family or from personal memory
B: From biography, autobiography, or news report
C: Speculative, rectified, or unverified source
DD: Conflicting data from multiple unverified sources
X: No birth time recorded
XX: Time known to be incorrect or withheld
City of Birth
State / Province
Country
Any Context on This Person?
Relationship to you, what you want to understand between you, anything relevant.
Additional Person 2
Name
Date of Birth
Time of Birth
Use 12:00 if unknown.
Birth Time Rating
select one
AA: Birth certificate or official hospital record
A: Quoted by family or from personal memory
B: From biography, autobiography, or news report
C: Speculative, rectified, or unverified source
DD: Conflicting data from multiple unverified sources
X: No birth time recorded
XX: Time known to be incorrect or withheld
City of Birth
State / Province
Country
Any Context on This Person?
Relationship to you, what you want to understand between you, anything relevant.
Additional
Astrology Background
How familiar are you with astrology?
select one
None: I know my Sun sign and that's about it
Casual: I follow astrology but don't study it
Intermediate: I know my chart and placements
Studied: I actively study or practice astrology
How Did You Find Me?
select one
Instagram
X / Twitter
Word of mouth
Google / web search
Referred by a past client
Other
Anything Else?
Anything you'd like me to know before we begin.
Terms & Conditions
✴
I have read and agree to the Terms & Conditions for this session.