California Client Information Form & Waiver
The purpose of this form is to give you some basic information on Reiki to take home.
What REIKI is:
Reiki is a form of Energy Healing. It is a complementary health care practice, which enhances the body's ability to heal itself.
What Reiki is NOT:
Your practitioner is not a licensed physician. REIKI is a complement to 'healing arts services licensed by the state of California', i.e., it is a complement to more traditional western medicine provided by doctors, nurses and hospitals. As a complementary or alternative medicine, REIKI does not require licensing by the state.
Nature of the Services Provided:
In-Person Reiki Sessions - the client lies down fully clothed. The practitioner places her hands on or above the body and allows REIKI to radiate from the hands. Similarly, Remote Reiki Sessions occur by phone or video (your choice), the client sits or lies down in a comfortable position, fully clothed. The practitioner uses a Reiki Bear in your place.
Theory of Treatment:
Stress, trauma and illness restrict the natural flow of Prana (Chi) “life force energy” through the body. By restoring “Prana” to the body, Reiki rejuvenates the body’s ability to relax and de-stress, and supports its ability to heal itself. In addition to the practitioner’s radiating the Reiki energy through his/her hands, sessions may involve the practitioner’s sweeping her hands above the body in various ways, or incorporating breath or vocal tones to break up energy blocks.
Heather Parker’s Qualifications:
Heather Parker is the founder of Soul Knowing Energy Healing. She is a Reiki Master/Teacher attuned in USUI/Holy Fire Reiki Ryoho and Seichem-Reiki. She was first attuned in 2015 by Jessica Miller and then attuned at the Master Level in 2016 by Brooke Roman. Heather has volunteered in the Reiki program at Huntington Memorial Hospital in Pasadena as well as worked with people within the United States and Canada.
Heather will tell you that her spiritual gifts amplified after being attuned in Reiki Levels 1 & 2. While Reiki is not a religion, we are spiritual beings, no matter our faith or religious affiliations, therefore, our attunement affects our spiritual gifts.
Client Acknowledgment: (Will be kept on file for 3 years)
I have been provided with a copy of the above document, in accordance with California state law SB 577:
Acknowledgement and Consent to Receive Services In order to use my services, California state law requires that you acknowledge receipt of the information provided in this form and that you sign it. I provide a copy for signature at our first visit. I will keep the original in my records for three (3) years.
- I have read and understand the above guidelines and disclosure about the treatments and techniques offered by Heather Parker, Reiki Practitioner, as well as her training and education.
- I have discussed with Heather Parker the nature of the services to be provided.
- I understand that Heather Parker is not a licensed physician, and that alternative services are not licensed by the state of California.
- I understand it is my responsibility to maintain a relationship for myself / my child with a medical doctor.
- I understand that Reiki is not a substitute for medical treatment or medications. I am aware that Heather Parker, Reiki Practitioner, does not diagnose illness or disease nor does she prescribe medications.
- I have consented to use the services offered by Heather Parker, and agree to be personally responsible for her fees in connection with the services provided.