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Reiki Healing Intake Form

Please provide your full name.

Please provide your preferred e-mail address. 

Distance Reiki sessions may vary in length depending on the needs of the client. Please choose from the drop-down menu above the length that you prefer.

Schedule a Session

Please choose the date and time from the menu below. Please note that week day sessions are only available in the evenings: 6:30 to 9:00 p.m. US Eastern Standard Time. Weekend sessions start at 11:00 a.m. and run through 6:00 p.m. US Eastern Standard Time.

Start Session

Choose a start time

End Session

Choose an end time

Please describe briefly your experience with Reiki energy (i.e. if you have received Reiki before – be it hands-on, or distance healing). If you have no prior experience with Reiki healing, please enter N/A.

Please list any focus areas and/or issues – be it health related, or emotional – that you would like this Reiki session to assist in resolving/alleviating. If you are scheduling this session for general wellbeing, with no particular focus in mind, please enter N/A.

Please feel free to share any other information that could be taken into consideration to facilitate meeting your personal goals for this session.


Reiki is an energy-based complementary healing modality and should not be considered as a form of medical treatment, or diagnosis. 

Select an item ($)
Thank you for booking a Reiki distance healing session!
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