Reiki Booking Form
Miss Eliesha at "In Katharsis"
Ensuring Client Confidentiality & Comfort
It's important to me that everyone feels safe and supported. Your well-being and comfort are my top priorities, and I want you to feel completely at ease during our sessions. Please know that any information you share with me will be treated with the utmost confidentiality and respect. I understand that discussing personal matters can be sensitive, and I encourage you to share as much or as little as you feel comfortable with. Your boundaries will always be honored, and I am here to listen, support, and assist you in any way I can on your journey.
Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Email
*
example@example.com
Age?
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What is your motivation for seeking Reiki treatment?
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This may include stress relief, pain management, mental health support, spiritual exploration, or relaxation.
Are you open to incorporating sound instruments into the session to enhance your healing experience?
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Please Select
Yes
No
Incorporating sound instruments can promote deep relaxation and balance your energy centers during the session, including tuning forks. Tuning forks emit frequencies resonating with the body's energy centers believed to promote relaxation, balance, and healing.
Have you received Reiki treatment before? If so, please describe your previous experiences.
How would you describe your current stress levels and overall well-being?
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Assessing your stress levels and well-being helps me gauge how Reiki can support you in achieving a state of relaxation, balance, and inner harmony.
How do you typically manage your emotions and handle stressful situations?
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This provides insight into your current emotional state and overall well-being. This information helps me customise the Reiki session to address any emotional imbalances or stressors you may be experiencing, ensuring a more effective and beneficial healing experience.
Are there any particular areas of your body where you experience tension or discomfort, that you would like me to focus on?
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Identifying areas of tension or discomfort allows me to focus Reiki energy where it's needed most, promoting physical relaxation and emotional release.
Are there any particular goals or intentions you have for this Reiki session?
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Clarifying your goals helps me customise the session to address your unique needs, whether it's releasing negative emotions, increasing energy flow, or enhancing spiritual connection.
Do you have any concerns or fears related to receiving Reiki treatment?
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Addressing any concerns or fears you may have ensures that you feel comfortable and relaxed during the session.
Is there anything else you would like to share or discuss before we begin the Reiki session?
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By offering you the chance to share any extra details, I ensure that all your needs, preferences, and concerns are fully acknowledged, promoting a collaborative and client-centered approach to the session.
Please provide the days and times you're available, and I'll do my best to schedule accordingly.
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Do you have any allergies?
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I incorporate various essential oils to enhance relaxation and promote healing. If you have any allergies or sensitivities, please let me know so I can ensure your safety and comfort during the session.
Reiki Energy
I serve as a channel for the universal life force energy to flow through me to you during the session. This energy is not my own; rather, it is the universal energy that is in all living beings. Through this process, we work to balance and cleanse your chakras, clearing any blockages and promoting relaxation, balance, and healing on physical, emotional, and spiritual levels.
Signature
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With Gratitude
Thank you for taking the time to fill out the consultation form. Your willingness to share your thoughts and concerns is greatly appreciated. Please know that everything you've shared is held in the strictest confidence, and I deeply respect your boundaries and trust. I am honored that you have chosen to embark on this journey with me. Your open-mindedness and trust are invaluable, and I am committed to providing a safe and supportive space for your healing process. I look forward to the opportunity to work together and support you on your journey to wellness.
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