Reiki Treatment 
Questionnaire & Waiver
Do you have a pacemaker? (Reiki can alter the rhythm)
Do you have Diabetes Mellitus?
Are you taking Insulin Injections?
Are you willing to closely monitor your insulin levels? (Reiki reduces the amount of insulin you are required.)



What to expect during a Reiki Treatment:


Reiki will go wherever it is needed. The type of reactions that may occur are:

A sensation of heat

A sensation of cold

See colors

Past life flashes

Involuntary movements

Fall asleep


Emotional responses

Rumbling stomach

Memory flashes

Pins and needles

Sense your hands moving

You may experience nothing. Reiki energy often works on a subtle level yet has profound results which normally become apparent in the following days or weeks. 

Your Submittion of this form is your Acknowledgement & Digital Signature