First and Last Name (required)

Your Email (required)

Present City & State of Residence

Phone

Birth Day, Birth Month, Birth Year

Birth Place

Birth Time

Birth Sex (add other details below)
MaleFemale

Accuracy of birth time and source (birth certificate, Mother, etc.)?

Have you had a Vedic Astrology consultation before (if so, list remedies you have done or are presently doing, including gemstones and mantras)?

Purpose of reading/what would you like to know: (You are welcome to include more than less to be able to get the most out of your reading):

[In the online forms, people tend to be very short with their answers. This form is to get the most out of your reading, and is as much for you as for the astrologer. Please clearly state what you wish to get out of the reading. Additional thoughts and questions can be added before the actual consultation.]

Additional chart information that may be needed (spouse/child/marriage date, disease diagnosis, treatment etc. according to the areas of focus):

Briefly describe your religious faith/views or spiritual practice (in case remedial measures are prescribed):

Method of Consultation:

In-personSkypeTelephone

Please detail who referred you to Freedom’s services, or how you heard about Freedom’s services?

Consent to Services and Waiver of Liability I have read and accept these terms

Is there anything else you’d like us to know?

Please enter the cede bellow and click the “Send” button: