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Reiki Client Consent Form

Date
Month
Day
Year

Reiki Consent and Acknowledgment

I understand and agree to the following:


I understand that Reiki is a gentle, hands-on or hands-off energy healing technique used for stress

reduction, relaxation, and personal growth. I acknowledge the following:

1. I understand that Reiki is a complementary healing modality and not a substitute for medical

diagnosis, treatment, or therapy.

2. I understand that the practitioner is not a licensed medical doctor, psychologist, or other

healthcare professional, and does not diagnose or prescribe medication or medical treatments.

3. Reiki may involve light, non-invasive touch or hands placed slightly above the body. I may request

no touch at any time.

4. Reiki may promote relaxation, emotional release, and increased well-being, but results vary and

are not guaranteed.

5. I agree to communicate any discomfort or concerns during the session to the practitioner

immediately.

6. I understand that I am responsible for my own health and well-being and for seeking appropriate

medical or psychological care when necessary.

7. I have disclosed any medical conditions, injuries, or concerns that may affect my Reiki session.


Confidentiality

All information shared during sessions will remain confidential and will not be disclosed without your

written consent, except as required by law.


Client Consent

By signing below, I acknowledge that I have read, understood, and agree to the information stated

above. I consent to receive Reiki from the practitioner and release them from any liability associated

with the session(s).

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