Astrology Consult Thank you for filling out this confidential form to enhance our work together. -Aly Name * First Name Last Name Email * Phone * (###) ### #### Date of Birth * MM DD YYYY Time of Birth * Hour Minute Second AM PM City, State, and Country of Birth * We'll be reviewing parts of your birth chart as well as your astro map - where your planetary lines go through different parts of the world. I'll review where you were born as well as where you live now. You can also have me look at 3-4 other areas of the world, please just let me know where you want me to focus. Anything else you would like to share? Thank you!