Reiki Client Information

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Email *

What is your full name? *

What is your phone number? *

What goals do you hope to achieve with Soul Led Movement Reiki sessions?

Where do you tend to carry stress and past trauma within your body? *

Are there any physical, emotional or health-related issues you are dealing with? *

Are you receiving other treatments to help with these issues? Please explain. *

Have you had a Reiki session before? If so, how was your experience?

Are you allergic to any essential oils or teas? If so, please explain. *

Do you grind, clench or have TMJ?

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Is there anything else you would like me to know to help make the most of your Reiki sessions? Everything is confidential and the more I know, the more I am able to customize your session and apply specific practices, such as sound frequencies, symbols, crystals, etc.

How did you hear about Soul Led Movement?

Emergency Contact, Relation, Phone Number: *

Send me a copy of my responses.

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