Let's gather information so I can pull and read your chart in preparation for our reading:
First Name | {"type":"text","name":"__generic","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
| Middle Name: | {"type":"text","name":"__generic2","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
| Last Name: | {"type":"text","name":"__generic3","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
|
Birthday:
{"type":"text","name":"__generic4","width":45,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
Time of Birth:
{"type":"text","name":"__generic5","width":45,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
City of Birth: {"type":"text","name":"__generic6","width":45,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
State of Birth: {"type":"text","name":"__generic7","width":45,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
Country of Birth: {"type":"text","name":"__generic8","width":45,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
Mothers Maiden Name {"type":"text","name":"__generic9","width":45,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}
What are your top 3 pressing questions you want to be answered (you can leave blank if you just want a free-flow reading)?
1. {"type":"text","name":"__generic10","width":95,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
2. {"type":"text","name":"__generic11","width":95,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
3. {"type":"text","name":"__generic12","width":95,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
Do you practice ancestral honor and veneration currently?
{"type":"text","name":"__generic13","width":95,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
If so describe your practice briefly? {"type":"text","name":"__generic14","width":95,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}