Client Identity
Collect full legal name, preferred name, date of birth, and contact details to ensure accurate identification and follow-up communications.
A complete Reiki Client Intake Form reduces risk by ensuring practitioners know relevant health and medication information, documents client consent, and supports continuity of care. It also creates a dated record useful for billing, scheduling, and professional oversight while helping meet privacy and retention obligations where applicable.
The primary user is the client, who provides personal and health details prior to the first session.
A licensed or certified practitioner who reviews the intake form to screen for contraindications, documents consent and session notes, and determines safe treatment modifications. They rely on accurate client-reported health details to make clinical decisions and to meet professional liability expectations.
An individual seeking Reiki who provides contact, health, medication, and consent information. The client must sign and date the form, disclose relevant conditions, and acknowledge any risks or limitations explained by the practitioner before care begins.
Collect full legal name, preferred name, date of birth, and contact details to ensure accurate identification and follow-up communications.
Ask about chronic conditions, recent surgeries, pacemakers, pregnancy, medications, and mental health history to screen for contraindications.
Document present symptoms, pain locations, emotional concerns, or recent events that inform session focus and technique selection.
Include a clear consent statement describing Reiki, potential sensations, limits of practice, and client acknowledgment of voluntary participation.
Record name, relationship, and phone number for urgent contacts; useful for same-day incidents or follow-up communication.
Provide space for session observations, modifications, and aftercare instructions to support continuity across appointments.
Show follow-up questions only when relevant, reducing client burden and improving data quality while preventing unnecessary disclosures.
Capture a timestamped signature with audit trail metadata so the practitioner has verifiable consent without requiring paper handling.
Allow practitioners to append session notes or amendments with date-stamped entries while preserving original client responses for auditability.
Provide PDF and CSV export to integrate intake data with scheduling, billing, or electronic health record systems where appropriate.
| Field | Configuration |
|---|---|
| Consent language | Require explicit checkbox and signature |
| Authentication | Email verification or SMS code |
| Conditional logic | Enable for health follow-ups |
| Storage | Encrypted at rest with access controls |
Choose a platform that secures data in transit and at rest and provides an audit trail for signatures.
Obtain a completed form and signed consent prior to initial treatment.
Request refreshed health and medication information at least once per year.
Have client complete a new form following surgery, hospitalization, or medication change.
Record the date when consent was signed for retention calculations.
Respond to client records requests within state timelines.
Create standardized template with required fields and consent language.
Client completes form online or on paper prior to session.
Practitioner confirms entries and client provides dated signature.
Store the signed form with restricted access and backup.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | Yes, 7-day free trial | No | No | No | No |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |