Healing Touch "L" Reiki Intake Form
Hello, and welcome to the exciting time leading up to our Reiki session! Filling out this form will help Lillie provide you with the best possible experience. The day of your appointment, please arrive on time, wearing soft, thin clothes (or bring some to change into), and bring a full water bottle. Further information can be found in the confirmation email that was just sent to you, and at HealingTouchL.com. Feel free to email any questions to info@HealingTouchL.com. I look forward to working with you!
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Email *
Your Name:
What are you hoping to get from this Reiki session? (Ex: Is there something in your emotions, life, or body you're hoping to shift from this gentle touch energy work?)
Is there anything I should know about your previous Reiki or bodywork experiences?
Are there areas of your body you would prefer the touch to be focused, or areas to avoid? (Ex: I could place hands just on shoulders or head, or could do the full body sequence, including arms and legs.)
Do you prefer more verbal communication during the session, or more silence?
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Do you have any sensitivities to scents (ex: candles)? Might you want a support pillow under your knees, or elsewhere? (The table is soft enough that most clients don't request extra supports, but they are available upon request!)
Do you agree to reschedule if you or the practitioner feel sick before the appointment? *
Do you agree to the following waiver? "I understand that Reiki is a Japanese form of relaxation: a simple, gentle, energy technique that is used for alleviating stress, pain management, stress reduction and deep relaxation. I understand that Reiki practitioners do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. 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. I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial. 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 understand that the practitioner will be sending energy to me for the duration of my Reiki session. I herby waive liability for the Reiki practitioner around any results of this session." *
For new clients: How did you hear about Healing Touch "L?"
Thank you!
For more information, check out https://www.HealingTouchL.com/ 
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