Reiki Client Contract — Feeling Being Therapy

Feeling BeingTherapy

Feeling Being Therapy

Newtownabbey, Co. Antrim

feelingbeingtherapy.co.uk

REIKI CLIENT CONTRACT

Date:

Client Details

Full name

Date of birth

Address

Phone number

Email address

Emergency contact name

Emergency contact phone

Health Information

Please indicate if you have any of the following conditions. This information is kept strictly confidential and helps ensure your session is safe and appropriate for you.

Pregnancy

Heart condition

Cancer / undergoing treatment

Pacemaker or implanted device

Recent surgery or injury

Epilepsy

Diabetes

Mental health condition

Any other health conditions, medications or allergies we should be aware of:

About Reiki

Reiki is a gentle, non-invasive energy healing practice that promotes relaxation and wellbeing. Sessions last approximately one hour and are carried out fully clothed. Reiki is a complementary therapy and is not a substitute for medical treatment. It does not diagnose, prescribe or cure any condition.

Informed Consent

By signing this form, I confirm that:

I have provided accurate and complete health information to the best of my knowledge.

I understand that Reiki is a complementary therapy and does not replace medical advice or treatment.

I consent to receiving Reiki healing from Feeling Being Therapy.

I understand I may end the session at any time if I feel uncomfortable.

I understand that results cannot be guaranteed and that experiences vary from person to person.

I am aware that Reiki may bring up emotions or physical sensations as part of the healing process.

Cancellation Policy

If you do not cancel within the 24 hour cancellation policy, full payment will be due for the session. To cancel or reschedule please contact Teri as soon as possible.

Confidentiality

All personal and health information shared with Feeling Being Therapy is held in strict confidence and will not be shared with any third party without your consent, except where required by law or where there is a risk of harm to yourself or others.

Signature

Client signature

Date

Practitioner signature

Date

Feeling Being Therapy · Newtownabbey, Co. Antrim · feelingbeingtherapy.co.uk