LIGHT TOUCHES CLIENT FORMPlease fill out this form as completely as possible so that I can better serve you. Name * First Name Last Name Email * Date MM DD YYYY Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Emergecy Contact Which session or class are you interested in booking? * *Reiki Readings/Intuitive Healing Combo Sessions *Light Touches Readings - 1.) Soul Touch Reading, 2.) Psychic Reading, 3.) Mediumship Reading, 4.) Akashic Records Reading *Business Bliss - Work Your Magic *Reiki & Energy Healing - Quiet Transformative Sessions *Breakthrough Channeling & Healings *Free-Spirited Channeling Sessions *The Umbrella Tree - The Secret of the Lesson *Heart Fire Healing *Crossover Connections *The Untethering *Galactic Soul Journey - Messages From the Stars *Transformative Sessions - Animal/Pet Sessions *Home/Office/Land Clearings - Remotely *Soul Magic Masterclasses *Holy Fire Reiki Attunement Classes What brought you to Light Touches? How did you hear about us? Have you had a Reiki Session, Healing (Holistic/Wellness session) Reading, Channeling or Spiritual mentor/coaching session before? Date of last session? Number of previous sessions? Do you have a particular area of concern? Are you sensitive to anything in particular? required (Alleriges, etc?) If yes, please describe Yes No Are you sensitive to touch? * Yes No Both Text Are you sensitive to energies? * Yes No Are you currently under a Physician's care? If yes, please provide name and contact info Yes No Please list all current medications and dosage I understand that Reiki, Energy healing, readings, energy clearings, channeling, spiritual mentorship, and coaching are simple, gentle, hands-on, or off (reiki/healing) energy and game-changer techniques used for assistance, stress reduction, transformation, relaxation, and relief. I understand Healing Practitioners/Coaches/Mentors do not diagnose conditions, nor do they prescribe or perform medical treatment, prescribe substances, or intercept therapy with a licensed medical professional. I understand that Reiki, energy healings, readings, channeling, clearings, holistic wellness coaching, or spiritual mentorship do not take the place of medical care. It is recommended that I see a licensed physician or licensed healthcare professional for any physical or psychological ailment I may have. I understand that Reiki, healing, and energy work can complement any medical or psychological care I may be receiving. I also understand that the body can heal itself and to do so, complete relaxation is often beneficial. I acknowledge that long-term imbalances in the body, mind, heart, home, and spirit sometimes require multiple sessions to facilitate the level of relaxation needed by the soul, body, and situation to heal itself. ⸻ Consent & Agreement 1. Liability Waiver I understand that Light Touches and its practitioners are not liable for any outcomes resulting from my session. I assume full responsibility for my own health, decisions, and well-being. 2. Scope of Services I understand that Healing Practitioners, Coaches, and Mentors do not diagnose, treat, or prescribe medications, nor do they interfere with medical or psychological treatment provided by licensed professionals. 3. Holistic Techniques I understand that Reiki, Energy Healing, Readings, Channeling, and other services offered by Light Touches involve holistic and transformational techniques that are meant to assist with relaxation, stress reduction, personal growth, and healing. These services are not substitutes for professional medical care. 4. Touch Consent I consent to light touch techniques as part of my healing session, if applicable. 5. Parental Consent (If applicable) I understand that clients must be at least 18 years of age to receive services. If under 18, I confirm that I have obtained parental consent for my child to participate in services provided by Light Touches. 6. Refund & Cancellation Policy I understand and agree to the Refund & Cancellation Policy. I acknowledge that a session fee is required to book and that rescheduling and cancellations must adhere to the specified guidelines. (Please see Light Touches Refund & Cancellation Policy) ⸻ I agree Privacy Notice: No Information about any client will be discussed or shared with any third party without written consent of the client or parent/guardian if the client is under 18. Thank you! REFUND & CANCELLATION POLICY