Human Design Intake Form

Nickname or name pronunciation tips go here.

I will be sending your reading and all communication to this address.

Month, day, and year.

Record hour and minutes. Note am or pm below.

If you do not have access to a birth certificate or recorded birth time, share as many details as you can about your estimated birth time above. For example: Were you born in the early morning or at night? Was it close to sunrise or sunset? Any other distinguishing information? If there is a large discrepancy in charts during your estimated birth window, I may want to ask you further questions to rectify your birth time.

This may sound strange, but your self-judgment is a powerful entry point for me as a reader. It can help me unlock golden nuggets for you. An easy starting point is completing the blanks: "I should be more/less __________." Go hog wild!