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Please fill out the following information for your reading. For your Grandparents, please provide both mother and father side. If you do not know the names of your Grandparents, place N/A in the space. All information will be kept confidential and will be deleted after our session is complete.

If you are adopted and do not know your biological parents, please place your adopted parents name in the space provided. You hold an energy signature with these parents and it will be shown within the records. 

Ancestral Alchemy Info Form

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