Energy By Kristina - Client Application Form

1

Name* This field is required. (Your information is private and it won't be shared with anyone)

First Name

Last Name

2

Email* This field is required.So I Can Contact You...

beyonce@example.com

3

Phone NumberOnly used if we need to confirm details about your booking.

Area Code

Phone Number

4

What prompted you to enquire today?* This field is required.

5

Have you had Reiki or guided meditation before?* This field is required.

6

Where would you prefer your session to take place?* This field is required.Most sessions take place at Yogarise Queen’s Park. Home visits are rarely available and are considered case by case. If agreed, an additional £80 fee applies depending on your location.

In YOUR home in London (additional £80)

In MY studio (27 Beethoven St, London W10 4LG)

Not sure yet....?

7

Are you currently under medical care, pregnant, recovering from surgery, or dealing with anything I should be aware of before your session?* This field is required.Please only share what feels relevant. Reiki is complementary and does not replace medical care or medical advice.

8

Consent* This field is required.Read Privacy Policy.

I understand that Reiki is a complementary practice and does not replace medical treatment, diagnosis or advice.

I understand I remain fully clothed during the session and can ask to pause or stop at any time.