Ember & Ease Reiki Client Questionnaire

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Ember & Ease Reiki Client Questionnaire

Creating a Session That Honors Your Unique Energy

1. What drew you to Reiki at this time?
(Feel free to share a bit about what’s going on emotionally, physically, or spiritually.)

2. Have you ever experienced Reiki or other energy work before?

Yes

3. Are there any areas in your life or body that feel like they need extra attention or care right now?
(Examples: anxiety, grief, chronic pain, lack of energy, insomnia, emotional overwhelm, etc.)

4. Any sensitivities or physical considerations I should be mindful of?
(Sounds, scents, touch preferences, mobility, trauma history, etc.)

5. Contact Info/ Email

Full name Consent to Treat

Submit

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