$100.00 USD

Have you ever had a Reiki session before?YesNo

I am... (choose one)18 years old or older.16 or 17 years old and will be accompanied by a paying parent or guardian.

Do you have a particular area of concern?

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 healthcare 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.I have read the above paragraph, and I acknowledge and consent to its contents.

Emergency Contact

How did you hear about us?

Message

Is there any additional information we should be aware of? This could involve the location where we'll meet, whether this is intended as a gift for someone, or any other alternative preferences you would like to indicate.

Signed: I agree to type my full name below to act as my signature for the above Reiki Client Information Form.

One 1-hour Session

One Session

What you'll get:

One 1-hour session
20% discount on your next session when you refer a friend and they pay for their first session with Teresa*
*Your name and their name must be mentioned at time of booking.