Client Information/Treatment Form
Jim PathFinder Ewing

I understand that Reiki, Shamanic and/or complementary, alternative, vibrational, energy medicine techniques are for stress reduction and relaxation. I acknowledge that treatments administered are only for the purpose of helping me relax and to relieve stress.

Reiki, Shamanic and/or complementary, alternative, vibrational, energy medicine practitioners do not diagnose conditions, nor do they prescribe substances or perform medical treatment, nor interfere with the treatment of a licensed medical professional. It is recommended that I see a licensed physician, or licensed health care professional for any physical or psychological ailment I may have.

I also understand and believe that the body has the ability to heal itself, and to do so complete relaxation is often beneficial. Long-term imbalances in the body sometimes require multiple treatments to allow the body to reach the level of relaxation necessary to bring the system back into balance.

I understand and believe that self-improvement requires commitment on my part, and that I must be willing to change in a positive way if I am to receive the full benefit of a Reiki, Shamanic and/or complementary, alternative, vibrational, energy medicine techniques treatment.

I acknowledge my commitment to my self-improvement process. I recognize that a Reiki, Shamanic and/or complementary, alternative, vibrational, energy medicine techniques treatment program must be followed to be truly effective, just as prescribed medication is only effective if taken as directed.

Treatment Form

Print Name:

Sign here:

(I agree that typing my name in the above space is the equivalent of my signature.)

Date:

Date of Birth:

Address:

City:

State:

Zip:

Phone:

e-mail address:

Ailment? List treatment requested:

 Soon we will add an email form, in the meantime, please copy and paste the Client Form into an email and send it to us. blueskywaters@att.net

Then pay the $40. non-refundable deposit, here: