I am over the age of 18 and understand that Reiki/Energy healing is a simple, gentle, hands-on energy technique that is used for stress reduction and relaxation. I acknowledge that the Reiki/Energy practioners hands/body will be very close to my own during my session. I understand that it is my responsibility to let the Reiki/Energy practioner know if at any point I am uncomfortable with how or where they are touching me. I understand that Reiki/Energy practitioners do not diagnose medical 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/Energy healing 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/Energy healing can complement any medical or psychological care I may be receiving, and that it will not exacerbate any medical conditions I have or am receiving treatment for by a licensed medical professional. 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.
By typing your name below and submitting this form, you are agreeing that all information you have provided is true and accurate to the best of your knowledge and that you agree the above Disclaimer.
If you have any questions about this form or my services, do not sign this form until contacting me.
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.
Patients under the age of 18 must be accompanied by a legal guardian