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Reiki Consent / Release Form

Before your session, please review the information below and sign and initial where needed:

What is Reiki?

The Usui System of Reiki Healing is a palms-on healing practice. Reiki is an ancient laying-on-of-palms healing technique that uses the Universal life force to balance the subtle energies within our bodies.


Reiki practitioners act as a conduit or channel through which universal energy travels. The intended result of receiving Reiki is a balanced: physical, mental, emotional, and spiritual being. Reiki is used today all over the world to support health, wellness, and transition.


My Reiki work generally utilizes a combination of:

          1) “hands-on” healing, and/or

          2) floating or hovering hands technique


While there is a protocol of hand positions, I work intuitively locating positions that require attention. My hands may rest lightly on your body or may float or hover above various body areas. If, at any time, you are uncomfortable, I can switch positions, or use the floating hands method. There is no difference in the benefit experienced by the placement of my hands on your body versus floating my hands over your body. Should you desire to alternate positions during treatment, please feel free to discuss any concerns that you may have.

What happens during a Reiki treatment?

During a Reiki treatment, you will lay fully clothed on a massage table, covered in a blanket if you choose, listening to soothing music. Your Reiki practitioner will lay their hands on your body in a series of hand positions to deliver universal energy throughout the body. A Reiki treatment generally takes place in the following order: first your head, then the front of your body and finally moving down and through the legs and feet. If the reclined position is uncomfortable, Reiki can be performed while you sit in a chair or while standing up.

What does Reiki feel like?

Reiki tends to feel warm and profoundly relaxing. You may feel the hands of the Reiki practitioner become hot or tingly. Some people describe a floating sensation and some see colors or shapes during the session. Some people fall asleep. Some experience emotional release. There is no expected experience; Reiki treatment is unique for each individual who receives it.


  • The most common results of Reiki treatment include:

  • · Reduction in stress

  • · Increased relaxation

  • · Enhanced sense of balance, centeredness and calm

What are the benefits of several sessions?

Just like meditation, or movement arts, the effects of Reiki are cumulative. While one session can work wonders, repeated, regular Reiki treatments can invite significant improvement. As an example: if you exercise for an hour, you will receive benefit. If you exercise every day for a month, the results will be much more profound. Reiki works similarly – regular sessions support well-being in every way.

Can Reiki "cure" me?

Reiki is a complementary alternative practice that works well on its own or in conjunction with other restorative treatments. Healing is often the result of gentle shifts in awareness, release of emotional patterns, achievement of new understanding, and daily practice. Reiki is not a replacement for traditional medical treatment.

  • I understand that Reiki is a relaxation and stress reduction technique.

  • · I acknowledge that treatments administered are only for the purpose of helping me relax and to relieve stress. Reiki practitioners do not diagnose conditions, nor do they prescribe substances or perform medical treatment, nor interfere with the treatment of a licensed medical professional.

  • · I further understand that Reiki treatment received from my practitioner is not to be construed as a substitute for medical examination, diagnosis or treatment. It is recommended that I see a licensed health care professional for any physical or psychological ailment I may have.

  • · I also understand that Reiki is an energetic healing methodology, which involves the laying on of hands. I understand that I will be fully clothed during the session, and experience a series of hand positions on and/or above my body.

  • · Having read, completed and understood this document, I request to receive Reiki treatment. I understand that my practitioner is providing Reiki treatment for me at my request, and is not responsible for the outcome of the Reiki session. I agree to hold my practitioner harmless for any intended or unintended result

As the parent/legal guardian, I understand and agree to the following:

Thanks for submitting!

Healing Stones
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