Reiki Client Information Form
This is form is a confidential document and will be reviewed and filed as such. The following questions are to gather information to support the Reiki service.
Name
First Name
Last Name
Email
example@example.com
Choose your Appointment
Have you ever had a Reiki session before?
Yes
No
Do you have a particular area of concern?
(By Typing your name below your agree to the following statement) "I understand that Reiki is a simple, gentle, remote or hands-on technique that is used for stress reduction, relaxation, clarity and more. I understand that Reiki practitioners do not diagnose conditions nor prescribe medication. I understand that my body has the ability to to heal itself and it will do so in divine timing. I will acknowledge my body and world consciously to recognize any drastic or subtle changes in my energetic field."
If you wish, please share the reason for the session below. Share any Physical, Emotional or Spiritual needs I should focus on for the intention of the session.
Submit
Should be Empty: