The information provided on this form will be used to provide me with updates and marketing. The form below is your opportunity to share your goals for your sessions as well as any concerns you may have. Once the client has completed the form, sit down with her or him and clarify any questions you may have. Canadian reiki association client information form i understand that reiki is a stress reduction and relaxation technique. Reiki treatment consent form ihavebeenadvisedthatifisuspectimayhaveamedicalcondition,ishouldseek helpfromaqualifiedmedicalpractitioner. It is a subtle and effective form of energy work using spiritually guided life force energy, and it is not affiliated with any particular religion or religious practice. I understand that reiki practitioners do not diagnose conditions nor do they prescribe or perform. I understand that reiki is a relaxation and stress reduction technique. I understand that reiki can complement any medical or psychological care i may be receiving.
You must complete and submit the form below prior to your first session with me. I acknowledge that sessions administered are only for the purpose of helping me relax and to relieve stress. Silver spiral reiki client treatment form client name. If client is a minor a parent or guardian must sign. It is essential that the client understands that no energy healing therapy can be accepted as a replacement for any. The client may feel this as a warm or tingling sensation in the body. Informedconsentandholdharmlessagreement reiki,energyread. Other clients instead receive the spiritual, mental and emotional tools to better manage their physical condition. Reiki energy comes from the godforce and is an extremely powerful healing energy. Reiki is a tibetan form of energy healing, rediscovered and promoted by. The art of reiki is a system of gentle vibrational healing that was established by dr.
Informedconsentandholdharmlessagreement reiki,energy. Reiki is the life energy that flows through all living things. The reiki practitioner places their hands on the client using light touch and no pressure or placing their hands just above the clients body. Tuesday, november 26, 2019 printable reiki client form, reiki client consent form, reiki client consultation form, reiki client form, reiki client information form, reiki client intake form, reiki client intake form pdf, reiki client waiver form edit. Reiki speeds the healing process, and provides a source of restoring energy while one is ill, under medical treatment, or in recovery. I understand that reiki is a stress reduction and relaxation technique. There have been times when one reiki session eliminated a client s longterm back pain. You can delve into the components of the system and the levels of training, as well as the traditional and nontraditional sacred symbols used in reiki practice. Download and print the massage therapy reiki intake form below pdf to fill out prior to our first session dont forget to bring it with you. Instead, educate clients and protect yourself with a reiki consent form. Ideally, clients understand the role that reiki plays in healing.
I also understand that the body as the ability to heal itself and to do so, complete relaxation is often. Release forms for reiki practitioners elemental chi. I understand that reiki is a simple, gentle, handson energy technique that is used for stress reduction. Reiki practitioners act as a conduit or channel through which reiki energy travels. In breaking the word down, rei is the universal, mysterious divine spirit and ki is. In the course of our reiki practices, though, it is important to keep at least basic records. View, download and print reiki client intake pdf template or form online. For the printable pdf version, see the link at the end of the article. Whenever you start working with a new client, have them sign a reiki consent form. Reiki client consultation form name reiki federation. No information about any client will be discussed or shared with any third party outside without written consent of the client or parentguardian if the client is under 18. Reiki client intake form reiki training, thai massage.
As a reiki practitioner sometimes the last thing on our minds is documentation for our practice. No information about any client will be discussed or shared with any third party without written consent of the client or parentguardian if the client is under 18. A typical session lasts for one hour and begins with the client lying down on a massage table fully. Please arrive at least 15 minutes early so you have time to complete the form prior to your scheduled session. These files are confidential and maintained in a secure location. All clients are encouraged to seek competent medical help when those services are deemed necessary. Reiki is at the top of my list of preferred energy healing techniques. Download the reikihealing touch intake form pdf from the blog.
My services neither diagnose nor prescribe for disease conditions. The client also receives a confirmation email, which includes the appointment date and time along with any pertinent details. Release form for ordained ministers in reiki practice this is the form that will ensure your clients understand that they are seeking spiritual counseling in the form of reiki treatment as a form of religious expression. Reiki pronounced raykey means universal life energy in japanese.
It also provides necessary information for my records. Reiki healing, classes, colorado springs derived its name from the word native, meaning. Its partly a matter of protecting yourself to know as much about your client as possible. Just wondered what others thoughts were about reiki consultation forms and the current practice of asking about clients medical conditions and medications. Reiki is a word used to describe the universal life force energy that is within and around all things.
Informed consent for reiki treatment healing heart center. Client record cards just download, edit and use reiki symbols. Please print, complete, and bring this form with you on your first visit. Please fill out and bring this intake form to your appointment. No information about any client will be discussed or shared with any third party without the written consent of the client or parentguardian if the client is under 18.
Your reiki experience have you received reiki before. Silver spiral reiki client treatment form 2016 page 1 all information given will be treated in the strictest confidence and stored in accordance with data protection legislation. A typical session lasts for one hour and begins with the client lying down on a massage table fully clothed, minus shoes and glasses if the client wears them. Basically the intake form should include your clients name, address, phone numbers, why they are seeking reiki general wellness, pain, stress, relaxation, etc. It is one of the few forms of healing that can be used to heal oneself. If you are aware in advance of any medical conditions they have you can be preapred for such circumstances.
Reiki 1 manual reiki 1 manual pdf a complete guide to the first degree usui method of natural healing. Sep 09, 2018 the reiki professional is now ready for the session, confident in knowing that a thorough and intentional preparation has been conducted on the clients behalf. Treatment consent form i understand that the reiki and energy healers do not diagnose illness, disease, or mental disorder. Cognitive behavioral therapy, pain management, chronic pain. Reiki is an ancient layingonofpalms healing technique that uses the universal life force energy to balance the subtle energies within our bodies and to heal.
Reiki speeds the healing process, and provides a source of restoring energy while one is ill, under medical treatment, or. I maintain detailed records of reiki sessions, including an intake form for new clients and a reiki treatment documentation form for every session. New reiki client intake form nutritionworks wellness. They work by drawing in the energy of the universe and channeling this positive, healing energy to the client. For example they could have a medical condition which gets worse for some unrelated reason and they could blame the reiki for making it worse. The information i have given is true to the best of my knowledge and i have not withheld any relevant information. Noticeofconfidentialityandyourightsasaclientandrecipientof reikiandhealingtouch yourexperiencesduringoursessionsareconfidential.
Healing and curing healing and curing are different things. Reiki is an ancient form of healing that is practised by the authors and numerous practitioners around the world. Reiki is a safe methods of healing and selfimprovement that everyone can use. For members own safety,no email addresses should be given on the open forums. I understand that reiki practitioners do not diagnose. Reiki is a form of hands on healing, with its origins in. Release of liability and consent to receive treatment form pdf descargar. Home about offerings schedulepay events writing resources more. I understand that reiki is a simple, gentle, handson energy technique that is used for stress reduction and relaxation. Reiki symbols for wealth reiki symbols hon sha ze sho nen reiki healer chakra healing energy healing with reiki reiki temple reiki store holistic training for your mind, body and soul since 1997. No information about any client will be discussed or shared with any third party.
Noticeofconfidentialityandyourightsasaclientandrecipientof reiki andhealingtouch yourexperiencesduringoursessionsareconfidential. Members shall advise clients that reiki is a complementary therapy and. The intended result of receiving reiki is a balanced physical, mental, emotional, and spiritual being. Personal history please check any conditions you have now.
Reiki sessions provided are complimentary to and separate from medical services. Reiki practitioners do not diagnose conditions, nor do they prescribe substances or perform medical treatment, nor interfere with treatment of a licensed medical professional. A printable form for medical offices with room to list information about a new health. As far as i know, there are not too many contraindications for reiki and it is deemed to be a safe therapy therefore why do we need to ask clients about their health in such detail.
They know it can complement traditional medicine rather than replace it. Reiki client information form kasey hitt, mdiv, csd. Reiki sound vibrational tuning form therapy crystal therapy other, please explain. Reiki session or any other activities that are part of cochrane reiki or its associated members, programs. Personal history please check any conditions you have now or have.
Canadian reiki association client information form. I understand that i may modify or delete my data at any time. Reiki supports and compliments all natural healthcare and conventional forms of medicine. Contact us live a meaningful life the international center for reiki training.
Emergency situations do arise, please call to discuss options, i am willing to discuss a pay it forward, probono, or sliding fee. Aug 03, 2018 while the client is completing this form, you can light a candle, turn on some soft music, and wash your hands or any number of things so you do not appear to be impatient while you wait for your client to answer the questions. I understand that reiki practitioners do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances. What reiki is reiki is a form of complementary health care practice, which enhances the bodys ability to heal itself. Client record cards just download, edit and use reiki symbols, sports massage. Reiki deal 25% off when you refer a friend and they book a 60 minutes reiki session. The intended result of receiving reiki is a balanced physical, mental, emotional. Nov 26, 2019 in person reiki client information agreement prior to a first time reiki session with peace bridge reiki llc all clients are asked to please complete and submit this new client information form and agreement. Preparing for the professional reiki session reiki rays. The ultimate guide to reiki this book is dedicated to my grandparents, parents, siblings. The purpose of this form is to give you some basic information on reiki to take home. Client intake and consent form for reiki treatments. Client registration form and confidentiality statement pdf descargar. Please use the private message pm or email buttons to contact other members.