Get Ready to Discover yourself!

Please fill this form out as completely and accurately as possible! This will help us find your most accurate time of birth!

This form may take a little time. I ask that you fill this out at least a week prior to your appointment.

Some Key points to filling this out!

1. Important dates and events, include times and locations - whenever possible.

2. For rectification purposes the date information is the “key”. If you prefer not to share a “confidential” or private life event, it’s not necessary to reveal what occurred – only the date of the event. A simple descriptive word (i.e. emotional - or physical- trauma, humiliation, devastation) will suffice.

3. As you go through the required questions, If a question doesn’t pertain to you just type NA

Disclaimer: Chart rectification is dependent on working together and being as open as possible. The goal is not always necessarily to find the same exact time on your birth record but to help you obtain a birthchart the actually work for you! Sometimes people find their charts down the road and they are different times so they want to revisit their rectification. So its also important to exhaust all efforts in finding the time before this. Sometimes the times on birth certificates are inaccurate as well do to circumstances. So even if you have a time of birth it may not feel right to you. So again its all about obtaining a WORKING birthchart. Which is what will benefit you more than anything.

Name

First Name

Last Name

Phone

(###)

###

####

Birth Date

Birth Location (City, State, County)

Best guess of birthtime

(expl: Time you were told, Day, Night, Morning, Evening, Afternoon, ect)

Birth of Children

First Job

Significant job changes (or endings)

Graduations & degrees from college

Special Honors

Broken Bones

Foreign travel (especially if significant to learning or growth process)

Serious injuries or accidents

Impactful deaths (best friend, parents, grandparent, spouse, siblings, child, etc.)

Impactful events (i.e. adult baptism, born again; degrees or honors, etc.)

Relocations

Meeting Significant other(s)

Marriage Date(s)

Divorces or separations

Where do you feel the most fortunate in life? Please give example

Where you do you find you biggest struggles have shown up in life? Please give example

The next questions are not required but helpful to know when narrowing down “houses” (areas of life represented in a natal chart).

What was happening in your life around 30 years of age? If your over 30.

Deepest wounding(s) life events?

What type of work do you do?

What are your hobbies and interests?

Do you feel you know your own path or Do others play a more significant role in your life?

Are you introverted or extroverted? In other words, open about who you are or do you prefer to keep things close to “the chest”

How do you release your tension?

What three things do you value above all else?

What three things do you LOVE above all else?

Where do you feel you “shine”?

Where do you expend most of your energy (last 3 or 4 years)? Note: progress Sun in Gemini (chatty last few years increased appetite for learning?

Are your emotions more fiery or earthy? (Fiery/sparkly Leo Moon vs Earthy Virgo)

Do you have an intuitive feeling about your birth time (or time of day, afternoon or evening)?

Do you ever see recurring numbers or clock times? If yes, what time?

Get Ready to Discover yourself!

Hurray! You did it!!! Talk to you soon!

Location

Contact