Reiki Intake-Established Client - OSW Spiritual Wellness

Name

Phone #

Emergency Contact Info

How long has it been since your last reiki session?

1-10

Has their been any significant change that I should be aware of?

If this is an in-person session, please check all that apply:

This session is in person - yes, I'm sensitive to touch. This session is in person - no, I'm not sensitive to touch. This session is a distance session and does not apply. This session is in person - yes, I'm okay with light touch. This session is in person - NO. I do not consent to light touch. This session is a distance session and does not apply.

What are your goals for this session?

What did you enjoy most about our last session?

CONSENT TO TREATMENT