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First Name

Last Name

Phone

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Birth Date *

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I hereby acknowledge and agree to the following regarding Reiki treatment for myself or my minor child: I understand that Reiki is not a substitute for medical treatments or medication prescribed by a doctor, but it can be a valuable complement to help me achieve my wellness goals. I understand there are generally no contraindications to Reiki. I understand that I may experience the relaxing effects of Reiki for hours or even days after a session, and it is recommended to avoid strenuous activities during this time. I understand that Reiki is a practice, and cumulative, regular sessions are often recommended for optimal benefit. I understand that it is recommended to drink plenty of water after a Reiki session. I understand that Reiki is an ancient Japanese practice system designed to promote wellbeing through relaxation. I understand that Reiki involves the practitioner's hands being placed on or just above the body in a specific order. I understand that I will remain fully clothed and will be asked to sit in a chair or lie on a Reiki table while the practitioner works. I understand that it is my responsibility to communicate to the practitioner if I feel uncomfortable or unsafe at any time during the session. By checking the "I Agree" box below, I confirm that I have read, understand, and agree to the terms outlined above. *

I AGREE TO ALL OF THE ABOVE