Intake Form Your answers help Kelly prepare a deeply personalized chart before your session. There are no wrong answers — just honest ones.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastPreferred Name (if different)Full legal name at birth *Used for numerological calculations — include middle name, keep it exact.Email *Date of Birth *Place of Birth (city, state/province, country) *Time of BirthAs exact as possible — check your birth certificate.How certain are you of your birth time? *Exact — from birth certificateApproximate — family recollectionUnknownCurrent Relationship Status *SingleIn a relationshipMarried or partneredSeparated or divorcingWidowedIt's complicatedPrefer not to say Name state/province, time? Do you have children? *NoYes — living at homeYes — grown or independentExpecting or tryingPrefer not to sayWhich areas feel most alive or most stuck right now? (select all that apply) *Relationships & IntimacyCareer & PurposeIdentity & Self-understandingFamily DynamicsMoney & ResourcesHealth & BodySpirituality & MeaningMajor Life TransitionHave you worked with astrology, Human Design, or similar systems before? *No — this is new territory for meA little — dabbled but nothing deepYes — I have some familiarityYes — I go deep into this workWhat are you hoping to understand or walk away with? *No need to be precise — even a feeling or a question is enough.Anything else you want Kelly to know before your session?Context, sensitivities, what you're carrying. This stays between you. This is a confidential form. Your answers are seen only by Kelly. By submitting you confirm your information is held privately and used only to prepare your session. [email protected] | @ancestrologySubmit
