Reiki Intake Form Deep Relaxation Name * First Name Last Name Email * Subject * ☺︎ Preferred Pronouns ⚘ Are you currently receiving other alternative treatments? * 〰️ Have you ever had a reiki session before? ✿ Do you have a particular areas of concern? ♡ How do you take care of you? ☾ What specific physical issues would you like to improve or heal? ☁︎ What specific emotional issues would you like to improve or heal? ꩜ What else are you doing to support you health and personal wellbeing? ✎ Please provide brief medical history. Particularly indicate significant data (injuries, accidents, surgeries, seizures, etc.) Thank you!
