All Prospective Astrology clients - Once an appointment has been scheduled, we require an intake form filled and returned to us at least 48 hours prior to our session.

The following options are available for intake:

  1. You may fill out the following intake form online, below.
     

  2. You can download an MSWord version of the intake form. You may need to click "Enable Editing" to fill it out. Fill out the form offline, save the completed file locally to your hard drive, then email back to: joey@heartswideopenwellness.com


     

  3. You can download the MSWord printable version of the intake form, and fill it out offline. Print it and bring to an in-person appointment.

Online Intake Form - Please ensure all areas marked with an * are filled out completely. You will not be able to submit this form until those fields have been entered fully. For any of the fields involving dates, you can select a year or month via drop down by clicking on the year or month, directly. This helps to speed up the process. If you experience any issues, you may download an MSWord version.

Intake Form for Astrology Consultations
Source of Birth Data

For this next section, I'd like you to list the key dates and descriptions of 3-5 major life events. This information is helpful for me lining up the events to dates in the horoscope. You can choose these at random, examples include (but not limited to) marriage/divorce, children born, school graduation, major moves, job start, etc.

Preferred Method of Consultation

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