Waiver Please fill out before services rendered. Reiki/Energy Client Information & Waiver Date* MM slash DD slash YYYY Name* First Last PhoneEmail* May we email you about future events and/or services?* Yes No Medical Waiver - Please read and check each box after understanding and agreeing to each of the statements listed below:* I understand that Reiki practitioners and herbalists do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. I understand that Reiki and herbalism does not take the place of medical care. It is recommended that I see a licensed physician or licensed health care professional for any physical or psychological ailment I may have. Reiki Waiver - Please read and check each box after understanding and agreeing to each of the statements listed below:* I understand that Reiki is a simple, gentle, hands-on energy technique that is used for stress reduction and relaxation. I understand that Reiki can complement any medical or psychological care I may be receiving . I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial. I acknowledge that long term imbalances in the body sometimes require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself. Energy Work / Reading Disclosure - Please read and check the box below after understanding and agreeing to each of the statements listed below:* All energetic/spiritual/shamanic readings of any type are for entertainment purposes only. Practitioner is not a medical or legal advisor and readings in no way constitute and/or replace legal, financial, medical or any other professional advice. License Disclosure - Please read and check the box below after understanding and agreeing to the statement:* Practitioner is a certified Reiki Master and herbalist and not a licensed physician. Treatment is alternative to healing arts services and what is provided is not licensed by the state. Please Type & Sign Signature Below:* Signature* Reset signature Signature locked. Reset to sign again