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The Reminder

NEW Reiki Client Information Form

How did you hear about us?
Do you give permission to be lightly touched?

I understand that Reiki is a simple, gentle, hands-on energy healing technique that is used for stress-reduction and relaxation. I understand that Reiki Practitioners do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. I understand that Reiki does not take the place of medical care. It is recommended that I see a licensed physician or health care professional for any physical or psychological ailment I have. I understand that Reiki can compliment any medical or psychological care I may be receiving. I also understand that the body has the ability to heal itself, and to do so, complete relaxation is often beneficial. I acknowledge that long term imbalances in the body sometimes require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself. 

Date
Month
Day
Year

Privacy Notice:

No information about any client will be discussed or shared with any third party without written consent of the client or parent/guardian if the client is under 18.

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