Vision Interaction

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Email

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Address

Street Address

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What are your goals for receiving Reiki?

Are there any injuries, surgeries, or recent health conditions that you feel the need to share? EG: Pregnancy

Recent Health Conditions / Injuries/ Surgeries / Pregnancy etc.. if applicable

Do any of these health conditions apply to you or do you have a history of?

If you have have any of the health conditions above please advise us who the health professional is who is presently treating the conditions as to aid us in providing a treatment best to suit your needs.

Health Professional if applicable

Essential Oils that you prefer or either may be / are allegic to?

Essential Oils if applicable

Are you presently on any medication/s? If so please advise

Present Medications if applicable

Are you currently receiving treatment for any condition? Physiotherapy, Chiropractic, Specialist, GP, Workcare, NA

Modality / Specialist if applicable

How did you hear about Vision Interaction Reiki?

Reiki is a healing technique that uses the universal life force energy to balance the subtle energies within our bodies to heal and contributes for balanced physical, mental, emotional, and spiritual being. Reiki is not a replacement for traditional medical treatment.

During a Reiki session, your Reiki practitioner will lay their hands on or/and above your body in a series of hand positions to deliver Reiki energy. You might feel a floating sensation, emotional release, increased relaxation, enhanced sense of balance, centeredness, and calm.

The effects of Reiki are cumulative in which regular Reiki treatments can invite significant improvement. Regular sessions support well-being in every way.

If you experience any pain or discomfort during this session, immediately inform the practitioner.

Please be mindful when you have booked your Reiki session that for 24 hours prior to the session if you could please limit / refrain from the use of alcohol / recreation drugs (if applicable of course) this isn't mandatory but will definitely ensure the optimum health benefits gained from your session.

Please note: Payment for a singular treatment session is due at time of session and pre-payment is required for all packaged series of sessions before first treatment session commences. Cancellations of less than 24 hrs may incur a cancellation fee.

Please be assured that your personal and medical information that you provide, consultations, treatments, sessions and outcomes will always remain undisclosed, private and confidential for all times.

(Ref VI Privacy Policy link on the VI Website home page)

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Please sign below if you acknowledge the given information and give your consent to recieve the treatment.