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Holistic Healer Business Toolkit

Client forms · F02

Reiki consent and preferences worksheet

Use this conversation aid to explain a nonclinical adult session and record practical choices. It is a starting draft for professional review, not a universal waiver or a substitute for ongoing consent.

FreeVersion 1.0.0
  • PDF
  • DOCX
  • Fillable PDF

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F02 · version 1.0.0

Free download. No email required. The DOCX is the structured, editable version for screen readers; the PDFs are print and fill-in copies and are not tagged. Resource license.

First page of the Reiki consent and preferences worksheet, blank: the practitioner's description of the session (service, duration, setting, what happens), the nonclinical scope statement, the client's touch choice with no option preselected, and comfort notes.
First page of the printable PDF · blank file

Who this is for

Practitioners offering an adult, nonclinical session who want a structured conversation aid to explain the service and record touch, comfort and pause choices before and during the session.

What the file contains

Service description
Practitioner completes: service name, setting, duration, and exactly what happens; required before client use.
Scope
Display the scope paragraph below in full; no checkbox substitutes for explanation.
Touch choice
Choose: no touch; discuss any proposed touch first; undecided and wish to discuss. No option is preselected.
Comfort preferences
Optional notes about positioning, lighting, sound, or access; 300 characters.
Pause signal
Preferred way to pause or stop: speak / raise hand / other discussed signal.
Questions
Questions discussed and any unresolved concern; optional 300 characters.
Choice
I choose to proceed / I would like more discussion / I do not wish to proceed; mutually exclusive.
Name date
Client typed/printed name and date; practitioner name/date; handwritten signature line for paper.

How to customize it

Fill in the actual service and discuss it aloud. Do not imply that agreeing to a session waives legal rights. Keep payment/cancellation policies separate from bodily consent. For minors, medical settings, or regulated services, obtain a separately reviewed process; this adult worksheet is outside those uses.

Scope and limitations

For adult, nonclinical sessions. It is a starting draft for professional review, not a universal waiver, a legally guaranteed consent form, or a substitute for ongoing consent.

Return completed forms only through the channel your practice designates, never to HolisticHealer.net.

Copy included in the file

This is a nonclinical wellness session. It does not diagnose, treat, or cure a health condition and does not replace care from a qualified health professional. No outcome is promised. You may ask questions, decline touch, change your preferences, pause, or end the session. We will confirm any proposed touch and your choices before and during the session.