Yosymban

admission

Readiness and alignment are quietly assessed.

Accurate birth data is required.

All information is handled with strict confidentiality.

Basic Information

First name*

Last name*

Email*

Location

Applying for:*

Myself

My Kid

I confirm I am legal guardian of the Kid

Birth Data

Day

Month

Year

Birth Time

Time

:HoursMinutes

Birth Location

Background

Previous psychotherapeutic or structured inner work?

Yes

No

If yes, please briefly indicate the type and duration.

Astrological background:

None

Informal

Consultative

Structured

Professional

If applicable, briefly describe your level or orientation.

Context

What are the primary needs emerging at this time?

Is there anything important you would like to clarify prior to review?

Terms and Consent

Prepared to engage in the 7-session cycle.

I consent to the use of fully anonymized and non-identifiable material for educational or case study purposes.

I understand this work is non-diagnostic and non-prescriptive.

I have read and agree to the Terms & Conditions.

Yosymban333 Ltd
Registered in England and Wales
Company No. 15990181
Registered Office: 71–75 Shelton Street, Covent Garden, London, WC2H 9JQ

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