REIKI & INTUITIVE ENERGY HEALING INTAKE FORM 

Personal Medical History

WHAT TO EXPECT 

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. Relaxing music is available if the client chooses, but is not required. We make every effort to ensure each client feels safe and comfortable. Before your session begins, you can discuss any of your thoughts or concerns. You can also choose to talk or ask questions during your session or relax and remain silent, meditate, or nap. The provider will work above your body or lightly place their hands on various parts of your body. If you do not wish to be touched please let your provider know. They will feel for places where the energy is stagnant or where the energy is deficient. They may work with the chakras, acupuncture meridian lines, and/or areas that they are drawn to work. You may let your provider know if there is a specific area that you would like addressed. Most people feel very relaxed as sessions allow for the release of physical, emotional, and spiritual pain or blockages. This allows the individual to begin making the necessary changes and shift awareness towards a more positive life experience. We find that energy medicine has a cumulative effect and so when you treat yourself to regular sessions, better health and well-being are natural outcomes. At the end of the session, you and your provider will discuss anything that came up during the session. 

Sessions including Vibroacoustic Therapy (VAT) are conducted in the same manner, however, the client will also be listening to an audio track through headphones, and experiencing vibration throughout their body via the mat they are lying on.

TREATMENT CONSENT FORM

I understand that the Reiki and Energy Healers do not diagnose illness, disease, or mental disorder. Nor do they prescribe medical treatment or pharmaceuticals. It has been made clear that energy healing and vibroacoustic therapy is not a substitute for medical examination or diagnosis and that it is recommended that I see a MD/ND for any physical or mental ailment. With this in mind I agree that the Reiki, Energy Healer, and Vibroacoustic Therapy Practitioners cannot be held liable for any problems that might arise that I think could be attributed to the energy healing/VAT session. I have stated all of my known medical conditions to my provider and if necessary I will keep her updated on my physical, mental, and emotional health. I acknowledge that Reiki and Intuitive Energy Healers practice for the purpose of providing mental/emotional/ physical and spiritual support using Intuitive Healing Techniques and VAT. 

** Vibroacoustic Therapy is gentle and safe for most people, however, if any of the following apply to you, please talk to your healthcare provider before receiving your session. 

Pregnancy, especially early stages Pacemakers or other implanted medical devices Heart conditions or unstable blood pressure Recent surgery, fractures, or injuries Seizure disorders or epilepsy Active infections, inflammation, or fever Blood clotting issues or certain circulatory conditions Severe mental health conditions that require medical supervision 

I attest that I have read the above, understand the nature of the treatment, and freely elect to receive treatments. I release the providers from any and all claims of malpractice, non-disclosure, or lack of informed consent.