Reiki Therapy Session (60 mins) Booking Form

Booking Form

Reiki Therapy Session (60 mins) Booking

Date of the session

Full name

Phone number

Date of birth

Have you experienced any Reiki therapy before?

Current health status:

How would you describe your diet?

How would you describe the level and type of physical activity or exercise you engage in, if any?

Do you consume alcohol?

Do you smoke?

Do you find it easy to relax and unwind?

How would you describe your sleep time and quality?

How would you describe your overall happiness and positivity?

Do you have any concerns related to anxiety or depression?

Are you currently taking any medications? (optional)

Do you have high or low blood pressure? (optional)

Are you pregnant? If so, how many weeks?

Do you use any hearing aids?

Do you have any metal implants? If so, where is it located? (optional)

Do you have any cardiac devices, such as a pacemaker or defibrillator?

Is there anything else you would like us to know to make your session more comfortable or effective? (optional)

What inspired you to a Reiki therapy session?

Are there specific outcomes you hope to achieve from this session?