NEW CLIENT RIEKI FORM Name First Name Last Name Is there anything that worries you about having a Reiki session? Most people do have some unspoken concerns. I can relieve your mind about a few of them. While I do have a cat and dogs in the house, they are never allowed in the Reiki Studio and you will problably never see them. The Studio is dust free as much as possible. Sheets, blanket, pillow case and eye covering are changed after each client. All working Crystals are cleaned after each use. I hope this helps. You will also be very safe. Have you had Reiki before? Yes No If so, approximately when was your last session Number of sessions you have had 1 Several Too many to count Is there a reason you stopped having Reiki? Do you have a particular area of concern you would like me pay special attention to? Are you sensitive to smoke from Sage or fragrances such as essential oils? Not sure No Yes Is light touch OK during your session as I work? I will never touch private areas or painful areas. Light touch is fine I prefer that you hover your hands over the area as you work How excited are you to have a Reiki session with me? CAN'T WAIT!! Strongly Disagree Disagree Neutral Agree Strongly Agree Thank you! Waiver Form
