Requests – The Karmic DF

Reading Request form
Customer Details:
Full Name*

First NameLast Name
Date*

MonthDayYear
Date
E-mail
example@example.com
Length of session purchased*
Topics for Reading*
15 Mn = 1 topic 30 Mn= 2 topics 60 Mn = 4 Topics
Notes that will help me with reading*
Will you be willing to submit review of my your reading?

YesNoMaybe
Upload Recent Pic Here*

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Should be Empty: