Astrology Client Intake Form

The astrology Client Intake form is used by professional astrologers to obtain information from their clients in order to prepare an astrological chart. The form asks for the client's name, date of birth, time of birth, place of birth, and other contact information. It also asks for the client's current situation, what they hope to gain from the consultation and other relevant information.

3 minutes to complete


A person who is above the age of 18 years is eligible to fill out the Astrology Client Intake Form.


Questions for Astrology Client Intake Form



What is your name?

The answer should be a text input.

Phone Number

The answer should be a phone number.


The answer should be a text input.

What is your date of birth?

The answer should be a date input.

What is your birth time?

The answer should be a text input.

What is your birthplace?

The answer should be a text input.

What are your current circumstances?

The answer should be a text input.

What are your goals?

The answer should be a text input.

What are your biggest challenges?

The answer should be a text input.

What is your biggest fear?

The answer should be a text input.

What is your biggest hope?

The answer should be a text input.

What do you want to learn from an astrology reading?

The answer should be a text input.

Forms Similar to Astrology Client Intake Form

  • Career Reading Client Intake Form
  • Financial Reading Client Intake Form
  • Past Life Reading Client Intake Form

Here are some FAQs and additional information
Astrology Client Intake Form

What will I learn in the consultation?

You will learn about your birth chart, as well as your strengths and weaknesses.

What information do I need to provide in the form?

In order to provide you with an accurate reading, we will need your full name, date of birth, and place of birth.

What are the three types of astrology?

The zodiac signs are divided into three major types ie. cardinal signs, fixed signs, and mutable signs. These three modalities of the zodiac sign are based on how we function and express ourselves in this world.

Want to use this template?

Loved by people at home
and at work

“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Editor's choice
BlockSurvey social proof
4.9 Star Rating

What's next? Try out templates like
Astrology Client Intake Form

1000+ Templates, 50+ Categories

Want to create secure online forms and surveys?

Join BlockSurvey.