Reiki Intake & Appointment Inquiry

Name *
Name
Numbers only
Phone
Phone
Are there any particular complaints or ailments?
Please list any treatments or medical history you think relevant to our session together. This information is confidential and will never be disclosed.
Please list or answer, "no."
Please check all Reiki add-ons you would like in your session:
If you are unsure of what some of these are, no worries! We can chat about them in person or via email before you arrive.