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PERSONAL CONSULTATION Information Form

With a wide variety of charts, the astrologer can discuss your aptitudes and problem areas in great detail.  We offer coaching to assist you in making the best of your personal talents and the conditions in effect.  If you're discussing a relationship, please provide birth data for both people on the order form. This is good to order around your birthday or as a birthday gift.

1 hour via Email with Stephanie - $180.00

CONFIDENTIALITY
ALL personal information gathered during the ordering and registration process is kept in strictest confidence. It is not released for any reason whatsoever.

*Required information

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*Name of the person paying for this service:

Personal Information about the person(s) receiving this service:
Name:
Gender (M/F):
Birth Date (M/D/Y):
Time of Birth:
Location of Birth:
Location at Birthday THIS YEAR:
2nd Person: Name:
2nd Person: Gender:
2nd Person: Birth Date (M/D/Y):
2nd Person: Time of Birth:
2nd Person: Location of Birth:
2nd Person: Location at Birthday THIS YEAR:
If you are ordering services where the Astrologer will be responding to your question(s), please provide them in the space below.:
"Timing is Everything" orders only: Please provide either 3 potential dates in the year, or a 3 month time period in which the event will occur, in the space below. :
"Timing Is Everything" orders only: Please provide event location in the space below.:
*Email Address:
Comments:
STEP 1:
Make sure that all of the above information is correct.

 

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