Reiki Client Information

Name *
Name
Phone *
Phone
Address
Address
Emergency Contact Information
In case an emergency situation were to arise:
Emergency Contact *
Emergency Contact
Emergency Contact *
Emergency Contact
Include conditions and medications that would need to be communicated to emergency services
Pre-Session Information
Reiki Medical Disclosure *
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 health care professional for any physical or psychological aliment that I may have. I understand 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.

Privacy notice:

No information about any client will be discussed or shared with any third party without the written consent of the client or parent/guardian if the client is under 18. Amber & Amethyst does not have a mailing list and you will only recieve emails in response of your request for communication.