top of page

Distance Reiki Consent Form

I, Robin Arnold, am a Reiki Master Practitioner & Licensed, Practicing Holistic Health and Acupuncture Practitioner.  Reiki is a gentle, complementary, energy technique based on Oriental Medicine and its approach to health and healing.  I do not diagnose or treat disease with a reiki session. These sessions are not a substitute for medical/lab tests, diagnosis or treatment from a qualified health practitioner for illnesses, injuries, or other medical conditions.

Basic Definition of Reiki: Reiki is an energy therapy based on the principle of Oriental Medicine in which practitioners consciously use their hands to convey subtle energies in a heart-centered and intentional way to support and facilitate physical, emotional, mental and spiritual health and healing.

Reiki is a holistic, complementary and integrative energy-based therapy that is accomplished through the practitioner’s use of contact and/or non-contact touch and a heart-centered state of being. The healing traditions of many cultures emphasize the importance of subtle energy systems that flow through and around the human body, affecting its health and vitality. Many of these traditions stress that balancing these energy fields can assist the body, mind and spirit in moving towards and maintaining wellness.

During a Distant Energy Session, it is best for Client to be comfortable and relaxed, noting any sensations or imbalances to assess the energy field.  I then choose a healing technique that is appropriate for your needs.  There is a high likelihood that you will experience the relaxation response during the session.  A feedback discussion or notification may follow. People have many different responses to reiki.  Some clients describe sensations of moving energy, deep relaxation, feelings of being supported and nurtured, or visions of images and colors. Some patients may experience an emotional release such as tears; or they may develop insight into specific areas of their lives. 

Aromatherapy (essential oils) may be used during a session, in the room, on practitioner’s hands.  Please advise before session if you desire to use or avoid specific or all oils.

If Client elects to have a Health Consultation session, we will discuss your various concerns, which may encompass lifestyle modifications, supplements, nutrition, and mind-body-spirit balance.   Before a distant reiki session, and during the consult, please advise of any known energy blocked areas, emotional distress, medical conditions, past trauma concerns, and any specific areas to direct our focus.

Thank you for letting me assist you in your health and wellness!

Robin Arnold,

Licensed & Board Certified Acupuncturist; Dipl.Ac. (NCCAOM®); B.S. Alternative Medicine; B.S. Health Science; M.S. Oriental Medicine; Certified Pyramid Feng Shui Practitioner; Inception Point Therapy® Practitioner, Reiki Master & Teacher, Certified Functional Medicine Practitioner.



By signing below, or submitting/replying with written consent acknowledgment to; you hereby understand and consent to the above scope of practice, and any future sessions as such.  You also agree to pay for services prior to or at time of treatment. 

Thanks for submitting!

bottom of page