Please tell me what has brought you to have Reiki therapy with me at this time?
Please tell me what outcome you would like to happen as a result of having Reiki therapy treatments with me?
Please list details of each diagnosed health condition you have, including:
How long you have had each condition
If you have been prescribed any medications for the condition.
How long you have had each condition
How each condition affects you day-to-day
Please add anything you feel is relevant for me to know about any conditions (or any past, or current injuries from which you are experiencing pain)
Any additional information you feel would be helpful for me to know, be that about your health, any special requirements, or any issues that require some sensitivity. (Simply leave blank if nothing else you feel is relevant at this point).