Client Intake Form

Choose your service*
- Reiki
- Psychic Reading
- Crystal Healing
Reiki Session*
Psychic Reading Session*
Crystal Healing Session*
Please choose a date for your session*
Dates are subject to change based on availability.
Date Format: MM slash DD slash YYYY
Please choose a time*
Times are subject to change based on availability. Times must be scheduled between 8AM and 6PM Monday - Friday.

: HH

MM
Name*
First Last
Email*
Phone*
Gender*
- Male
- Female
Address*
Street Address Address Line 2 City State ZIP Code
What are your goals for receiving Reiki?
- Pain Relief
- Addressing a traume
- Relaxation
- Other
Are there any injuries, surgeries, or recent health conditions that you feel you need to share?
Consent
I agree to the terms and conditions.
Total
$0.00

Contact

Email:
[email protected]
Phone:
(630) 561 - 7620

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What is Reiki?

Reiki is a simple, natural and safe method of spiritual healing and self-improvement that everyone can use. It has been effective in helping virtually every known illness and malady and always creates a beneficial effect. It also works in conjunction with all other medical or therapeutic techniques to relieve side effects and promote recovery.

A treatment feels like a wonderful glowing radiance that flows through and around you. Reiki treats the whole person including body, emotions, mind and spirit creating many beneficial effects that include relaxation and feelings of peace, security and wellbeing. Many have reported miraculous results.

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