Client info    

The more I know about you the more accurate my readings can be. There's no reason I should have to divine things you could tell me, and the more you enter here, the less time that will be spent on the reading.

If you call without filling out this form, at least be prepared to answer a few questions, and know which, if any, of the checkboxes you disagree with. I need to know the items in underlined red print. Those in fuchsia print are also important.

I also recommend the The SelectSmart Religion Selector which asks about your beliefs and gives a thorough percentage breakdown of what religions you could be said to believe in. It has it's own discussion group and result forwarding.

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- I have read, understand, and agree to abide by the 'Disclaimer, limitations, and privacy' agreement.

Contact

Handle for online purposes:    (password advice)

Name for billing, shipping, and disclaimer agreement:

Email :

Phone , Best hours & notes:

2nd Phone , Best hours & notes:

Mailing address , Mailing State Zip or postal code:

ICQ# , Website address:

Privacy

Please read the above disclaimer & privacy section

Here are levels of privacy I can maintain for you. Please select all you are comfortable with:

- Erase all traces of my visit (excepting IRS income log)

- Allow audio recordings or text transcriptions solely for legal defense

- Keep a consultation journal so you can recall my issues better.

- Save journal information you can use to study patterns in tarot

- Discuss my case with colleagues while protecting my identity

- Feel free to post non-identifying excerpts as necessary to discuss your work.

- I have no reservations about content. Post any excerpts you want

- Post my complete reading transcripts affiliated with my handle so me and my friends can access them.

- Write my name and phone number on public walls, perhaps some exotic ones found on mountain top restrooms.

Privacy comments:

Psychic Privacy:

- Only channel me during readings and preparations

- Channel only external views of my circumstances and inner-being status, do not experience my inner being.

Mailing list

- Contact me confidentially with further elucidations of my reading, advice, or make personal inquiries about my well being.

- Send inquiries, special offers, and holiday greetings from your business

- Send me your metaphysical newsletter with poems, meditations, research links, etc.

- Inform me of site updates

Personal & family

Gender: F/M/dts:

Age ; Date-of-Birth ; Country of Birth:

# of brothers and sisters:

Marital history & parental status:

Relationship status & quality:

# of children:

Your age at birth of first child:

Age of your youngest child:

History of trauma or sexual abuse?:

Involvement with and attitude towards family, friends, & strangers.:

Occupation, involvement:

Use of spare time, personal interests:

Satisfaction with life:

Religious Exposure & Current Religious Beliefs, Level of spiritual attainment:

Doubts & faith issues, Mental, emotional, or spiritual reality integration difficulties:

Health history & current complaints:

Favorite color:

Favorite movie:

 

Interest Survey

- Simultaneous card layouts on the web during the reading.

- Net phone or instant voice mail services ie Net2Phone, StarTrek communicator, etc. - specify

- Improved free automated readings.

- Expanded site content - specify:

- Expanded metaphysical services:

 
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