Intuitive Energy Treatment Consent Form
Please read and consent to the terms below and fill out your personal information.
Patient Name
First Name
Last Name
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
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Are you currently taking any medications or undergoing any medical treatments? If so, please specify:
*
Please describe any specific goals or intentions you have for this energy treatment session:
Date of Session:
*
-
Month
-
Day
Year
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Consent for Touch (if applicable):
*
Yes
No
Terms:
*
I understand that this treatment is non-invasive and is intended to support my overall well-being. I acknowledge that the practitioner may use various techniques such as Reiki, energy clearing, or intuitive guidance during the session.
Signature
*
Continue
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Should be Empty: