I can't wait until our session together! Please answer the questions below. Thank you!
How did you find me?
Referred by family or friends Social media Website Google Other {"type":"checkbox","name":"findme","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please check at least one item.","options":"Referred by family or friends\nSocial media\nWebsite\nGoogle\nOther"}
If you were referred by a person, what is their name?
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Medical and Spiritual Wellbeing Please describe any medical issues that you are experiencing. {"type":"textarea","name":"__generic2","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
Do you understand what Reiki is? Yes Not at all A little bit {"type":"checkbox","name":"__generic3","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please check at least one item.","options":"Yes\nNot at all\nA little bit"}
Have you had a Reiki session before?
Yes No {"type":"checkbox","name":"__generic4","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please check at least one item.","options":"Yes \nNo"}
Have you had an intuitive reading before? Yes No {"type":"checkbox","name":"__generic5","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please check at least one item.","options":"Yes\nNo"}
Please acknowledge the following items:
I understand that Reiki is a simple, gentle, hands-on, or distant energy technique that is used for stress reduction and relaxation. I understand that Reiki practitioners do not diagnose conditions; prescribe or perform medical treatment; prescribe substances; or 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 ailment I may have. I understand that Reiki can complement any medical or psychological care I may be receiving and that the body can heal itself and to do so, complete relaxation is often beneficial. I understand that long term imbalances in the body sometimes require multiple sessions to facilitate the level of relaxation needed by the body to heal itself. I understand that no information about me will be discussed or shared with any third party without my written consent. {"type":"checkbox","name":"__generic6","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please check at least one item.","options":"I understand that Reiki is a simple, gentle, hands-on, or distant energy technique that is used for stress reduction and relaxation.\nI understand that Reiki practitioners do not diagnose conditions; prescribe or perform medical treatment; prescribe substances; or interfere with the treatment of a licensed medical professional.\nI 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 ailment I may have.\nI understand that Reiki can complement any medical or psychological care I may be receiving and that the body can heal itself and to do so, complete relaxation is often beneficial.\nI understand that long term imbalances in the body sometimes require multiple sessions to facilitate the level of relaxation needed by the body to heal itself.\nI understand that no information about me will be discussed or shared with any third party without my written consent."}
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