—I confirm I am at least 18 years of age, or have parental / guardian permission.
— I have elected, by my own decision, to have a Reiki therapy session.
— I confirm that I am not under the influence of recreational drugs or alcohol.
— The procedure, including the process and objective, has been explained to me before undergoing Reiki.
— I understand that Reiki is a simple, gentle, hands-on energy technique used for stress reduction and relaxation.
— I understand that a Reiki session is not a substitute for medical or psychological diagnosis and treatment. I also understand that it is not massage therapy.
— I understand that 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 participation is voluntary and that at any time I may choose to end my participation.
— 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 been given the opportunity to ask questions regarding any benefits, risks, or possible complications of the procedure.
— I have followed all pre-treatment care instructions as they have been explained to me.
— I understand all aftercare procedures for Reiki as they've been explained, and I intend to adhere to the instructions given to me.
— I understand that it is important to provide feedback during my treatment, and I will inform
my Reiki Practitioner of any pain or discomfort during the session.
With my signature below, I confirm that I have read fully and understand the information in this consent form and the details included. I have provided an accurate account of my medical history, including any medications I take or intend to take, and any medical procedures I intend to undergo. By signing below, I agree to accept all and full responsibility for risks, injuries, damages, or side effects that may occur as part of the procedure. I will not hold my Reiki Practitioner (recorded below) responsible for any conditions present, but not disclosed at the time of treatment, that may affect treatment.