Provider-Prov Sem Info & Registration

Offer your profound healing gifts!
LifeSpark Provider Training

Live Interactive Training: 2025 Dates
(choose one)
- Sat, Sep 20, 9 am to 1 pm MST Via Zoom
- Sat, Nov 15, 9 am to 1 pm MST Via Zoom
LifeSpark Training Includes:
- Live Interactive Session (4 hours)
- Tech training for scheduling and Zoom (1.5 hours)
- Self-Paced Learning Experience (4-6 hours)
Requirements
- You must already be trained in Reiki or Healing Touch (Minimum Level II/Second Degree)
- You need at least 50 full sessions of experience before signing up with LifeSpark
What You'll Gain
- Experience the deep fulfillment of supporting someone with cancer.
- Enhance your healing abilities and practice through this professional development training program.
- Join our vibrant community of nearly 100 Reiki and Healing Touch providers.
- Provide sessions at partner hospitals and other spaces, or work remotely.
Registration Process
- Complete the Registration Form (click Next below)
- Pay the $99 registration fee
- Begin your LifeSpark journey
Ready to Make a Difference?
Register on the next page to start your journey as a LifeSpark provider!

Registration / Enrollment Form

To become a LifeSpark Reiki or Healing Touch volunteer provider.
Training Date
Full Legal Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Which modalities and levels have you completed?

Healing TouchReikiHTCP or CHTPReiki Master
ENERGY WORK TRAINING: List all Reiki and Healing Touch classes you have taken, and other modalities you are trained in. Use this format: Modality (ie Reiki); Class level (ie Second Degree class); # of hours of class (ie 8 hrs); Teacher name (ie Jane Doe); Date of class (ie 4/2005)
# of years you have practiced Reiki.
If less than a year, estimate a % (example: 4 months = .33, 8 months - .66)
# of years you have practiced Healing Touch.
If less than a year, estimate a % (example: 4 months = .33, 8 months - .66)
Approximate # of Reiki/Healing Touch sessions you have given in last 2 years.
List Reiki/Healing Touch classes you have taught. Include # of students in class, and date.
Where have you practiced?

HomeOffice spaceMedical facilityOther
Availability

WeekdaysEvenings/wkndsFlexibleOther
Employer
EDUCATION

Grade SchoolHigh SchoolSome collegeCollege DegreeSome grad schoolGrad DegreePost GradTrade school
List other education or training that may assist you in this program.
List health care licenses you hold including Type of License, License #, and State
List experience working with seriously ill people.
List volunteer or leadership experience.
What is your current physical and emotional health status?
Do you have any physical limitations that could effect your participation in this program?
Do you have any concerns associated with working with cancer patients?
Please describe your self-care program.
Have you every experienced a loss through death? If so describe briefly.
Tell us why you would like to participate in this volunteer program.
REFERENCES: Please list three professional references (supervisors, colleagues, teachers, clients). Include at least one who is familiar with your Reiki or Healing Touch work. Include name, phone, and email.
We conduct criminal background checks on volunteers and will ask for the following information: Social Security Number and Date of Birth.

I give permission for photos to be taken of me at LifeSpark events and acivities. These photos will be used to market and support LifeSpark.

The information that I filled out on this form is correct and true to the best of my knowledge.
Name

First NameLast Name
By typing my name on this form, I agree to the above conditions.

First NameLast Name
Date

MonthDayYear
Date
Please attach copies of your Reiki /Healing Touch training certificates.

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