Energy Healing

Consent Form

All information is held in the strictest confidence. At no given point this information is disclosed or shared without client’s written consent.

You may choose to skip answering any non-require question you feel impinges on personal information you do not wish to disclose.


Fields marked with an * are required.

*TREATMENT CONSENT FORM I understand that the Reiki and Energy Healers do not diagnose illness, disease, or mental disorder. Nor do they prescribe medical treatment or pharmaceuticals. It has been made clear that energy healing is not a substitute for medical examination or diagnosis and that it is recommended that see a MD/ND for any physical or mental ailment. I agree that the Reiki and Energy Healers cannot be held liable for any problems that might arise that I think could be attributed to the energy healing session. I have stated all my known medical conditions to my provider and if necessary, I will keep him/her updated on my physical, mental, and emotional health. I acknowledge that the Reiki and Intuitive Energy Healers at Island Massage by Daniel practice for the purpose of providing mental/emotional/physical and spiritual support using Intuitive Healing Techniques. I attest that I understand the nature of the treatment and freely elect to receive treatments. I release the providers from all claims of malpractice, non-disclosure, or lack of informed consent.