I hereby request you to inform me concerning the planetary forces active at the time of my birth and at other times during my life, the dates of which I will give you. I affirm that these are true and accurate dates and times to the best of my knowledge.
In furnishing me with this information, I understand that you obtained charts constructed by you, and from textbooks covering the art/ science of astrology and astronomy.
I understand that you make no claim to any special or occult power and that the information you will furnish will be only that which any thorough student of astrology would give me.

I understand that I am not asking you to tell my fortune in any sense and understand that you do not attempt or pretend to do so.

I understand that all information provided herein is based on astrological theory and geometric analysis. It is presented for educational purposes with reliable intent. However, no claims for future accuracy is made, nor can projections be guaranteed. Also, reliance of information in this consult and any report is solely at my risk and absolutely no one else’s.

I understand and accept that all information provided, and advice given is not intended to take the place of the same delivered from other professionals, such as medical doctors, accountants, attorneys, financial advisors, psychiatrists or psychotherapists.