HUMAN DESIGN APPLICATION

Thank you for your interest in a Human Design reading.

Human Design readings depend on accurate birth information and thoughtful preparation. This short application helps me review your birth details and understand what has drawn you to explore your design.

Please answer as carefully as you can. There is no need to get everything perfect. If you are unsure about your birth time, simply explain what you know.

Once I review your information, I will reach out to discuss next steps.

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First name

Last name

Phone

Birth time (if known)

Birth Day, Month and Year

City, State, Country of birth

Birth Time Accuracy - How confident are you in your birth time?

Exact (from birth certificate or hospital record)

Very confident (family memory within a few minutes)

Approximate (within about 30 minutes)

Approximate (within about 1 hour)

I do not know my birth time

If your birth time is approximate or unknown. Please share anything you know about your birth time and where the information came from. For example: a parent’s memory, hospital estimate, or birth certificate notation.

What drew you to explore Human Design at this time?

What is happening in your life right now that you hope a reading might help illuminate?

Have you had a Human Design reading before?

Yes

Self Studied

I'm familiar with it a bit, but just a little

Is there anything else you would like me to know before reviewing your application?

Thank you for taking the time to complete this application.

After reviewing your birth information, I will reach out to discuss whether your chart can be read accurately and the next steps for scheduling your intake session and Human Design reading.

Warmest Reflections;
🕊 Jo-e

L O V E Y O U R W A Y T O H E A L T H

Jo-e Sutton, CHHC, Certified Holistic Health Counselor

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