Sophia Venus Appointment Form

You may book an appointment with Arielle using this form.
Please fill it out with your desired date/time (including time zone) and submit the form.
Preferred Appointment DATE/TIME
  date (mm/dd/yy) time (time zone)
1)
2)
3)
please note that the dates & times that you choose may not be available - please indicate below the preferred day of the week and preferred time for your appointment in case the above date/times are unavailable - we will try our best to accommodate your request
Mon       Tue       Wed       Thu       Fri
Morning       Afternoon
SECTION ONE: SERVICES
Please select one or more of the following:
NATAL    PROGRESSED    RELOCATION: US    WORLD    RELATIONSHIP
SECTION TWO: PERSONAL INFORMATION
Please provide the following information about yourself as completely as possible:
NAME:
ADDRESS:
CITY, STATE, ZIP:
TEL (day): (night): FAX:
EMAIL ADDRESS:
REFERRED BY:
Accurate and complete birth data is essential for these services:
DATE OF BIRTH (mm/dd/yyyy)
TIME OF BIRTH:    AM    PM
PLACE OF BIRTH: (city, state, country):
SECTION THREE: MAJOR QUESTIONS
Please list MAJOR QUESTIONS for Arielle to address during your session
please note that there are not a specific number of questions that you need to ask
SECTION FOUR: QUESTIONS FOR RELOCATION SERVICES
If you are requesting RELOCATION services, please answer the following:
1) How long have you lived in your present location?
2) List other places you have lived for more than two years:
3) Do you wish to relocate, or just travel?
4) What places (city/state/country) are you MOST interested in finding out about during this session? Please list several places; Arielle may suggest additional locations after reviewing your maps.
5) List any restrictions you may have on relocation (eg: no cold weather, no humidity, no large cities, etc.):
6) What is the most important feature for you in finding a compatible place to live or travel to?
SECTION FIVE: QUESTIONS FOR RELATIONSHIP SERVICES
If you are requesting COMPATIBILITY services, please answer the following:
1) Birthdate, birthtime (am or pm) and birthplace of significant other:
2) How long have you been together? (months/years)
3) Most important questions about your relationship:
SECTION SIX: Please list here anything else you think is important for Arielle to know: