Order Form
Your name:
Your e-mail address:
Your phone number (optional, but sometimes
helpful)
Your current location
Month, date and year of birth
(Please write out month)
Your time of birth (specify AM or PM)
Your city of birth.  If you were born in a small town, what is the name of a larger
town nearby?
Special questions or concerns, and
birthdata of anyone else involved
Choose the kind of reading you'd like, and click on "Submit".
To order your reading, fill out the following
information and click submit.  More details about the
various readings I offer can be found  
here.  If you
have questions about what I do, please feel free to
contact me.

Contact me at:

When filling out the form below, be especially careful
in typing in your email address.  

I will contact you to confirm the information and to
work out any details.