Reiki Client Notes
First / Last name
Email address
Phone number
Reason for Session
Clear choice
Relaxation & Stress Reduction
Physical
Emotional
Mental
Spiritual
Level of stress in life (rate from 0-10)
Reason needed for relaxation and stress reduction:
Reason for Session - Physical
Reason for Session - Emotional
Reason for Session - Mental
Reason for Session - Spiritual
Changes since last session
Observation before
session
Observation after
session
Results of Card Reading
(if applicable)
Notes Post Session
Home care suggested
Follow up plan
Verification
SUBMIT FORM
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