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Human Client Intake Form

Danielle Lehr - Dani's Divination

Please complete the following form for human clients.

*First name

*Last name

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*Are you currently under the care of a physician or specialist?

Yes

If so, please specify what for if comfortable:

*Have you ever experienced Reiki or any other Energy Healing?

Yes

Not sure

*Do you have difficulty laying on your back for up to an hour?

Yes

Not Sure

*Are you comfortable with me appropriately placing my hands on you during your session?

Yes

Please ask first

What are your goals while receiving energy healing/coaching?

Is there anything else you'd like me to know about while working with you?

I understand that Reiki and other healing modalities are alternative techniques for stress reduction and relaxation that can improve your health. My practitioner does not diagnose medical conditions, nor do they prescribe or perform medical treatment.

I understand that I am fully responsible for how I may discern and/or act upon any insight or guidance that I am given. No legal or medical advice will be given.

I understand that it is recommended that I also consult a licensed physician or health care professional for any physical or psychological ailment I may be experiencing at any time.

I understand that all session rates include consultation, energy work and/or coaching. 100% of session fee is due upon scheduling for the first appointment.

I understand that No Show or cancellation of any future appointment is subject to owing 50% of total fee for missed appointment before rescheduling.

I understand that energy work and coaching is not a guaranteed one-time fix for any issue I may be experiencing. Multiple sessions are often advised.

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Disclaimer: © Content from this site is not intended to be used for medical or legal advice. The information provided on this site is intended for general consumer understanding. Anyone seeking medical and/or legal advice is strongly advised to consult a licensed professional regardless of what he/she may read on this site. Do not disregard medical opinion or make any changes to your medical plan based on what you may read on this site. You are solely responsible for all decisions you make regarding your health. All services and content provided through this website are intended for spiritual, educational, informational, and personal growth purposes only. Energy healing, intuitive guidance, spiritual counseling, Reiki, and related holistic services are complementary wellness practices and are not substitutes for licensed medical, psychological, legal, or financial advice, diagnosis, or treatment. No guarantees or specific results are promised. By using this website and services, you acknowledge personal responsibility for your own decisions, interpretations, and outcomes. Practitioners do not diagnose conditions, nor do they perform medical treatment, prescribe substances, or interfere with the treatment of a licensed medical professional.