• NoNo's Essential Reiki Healing

    Client Information Form
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Are you currently under the care of a physician?
  • If yes, when was your last session?
  • I understand that Reiki is a simple, gentle, hands-on energy 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 licensed health care professional for any physical or psychological ailment I may have. I understand that Reiki can complement 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.

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  • Date
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    2 digit month, 2 digit day, 4 digit year
  • 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.

    ICRT Reiki Membership Association

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