Reiki Session Preparation & Energy Alignment Form

Prepare for your Reiki session with this energy alignment form. Designed for distance and in-person Reiki healing at ReiAlign to support clarity, intention, and balance.

Sacred Listening sessions do not require completion of this form. Please scroll to bottom to complete sacred listing guidelines agreement. If you plan to book a fusion session, complete both forms.

Name*

Last name

Your email*

Phone Number

Date of Birth*

Session Type *

Distance Reiki

In-Person Reiki

You Intention*

Physical Body Awareness Reiki honors the body as a messenger. Are there specific areas of your body you would like Reiki energy to focus on?*

Head / Mind

Neck / Shoulders

Heart / Chest

Solar Plexus / Digestive Area

Lower Back / Hips

Knees / Legs / Feet

Full Body / General Support

Other (please specify):

Physical Body Awareness*

Emotional & Mental Landscape Energy often reflects what the heart and mind are carrying. Are you currently navigating any emotional patterns or challenges?*

Stress or Burnout

Anxiety or Overthinking

Grief or Loss

Emotional Fatigue

Difficulty Resting or Sleeping

Feeling Disconnected or Unclear

Other (please share):

Is there anything you are ready to gently release or soften?*

Energetic & Abundance Flow Reiki supports balance across all areas of life. Do you feel you are experiencing any energetic blockages related to abundance, flow, or receiving?*

Financial Abundance

Creative Flow

Career or Purpose Alignment

Self‑Worth or Receiving Support

Relationships

General Energy Stagnation

Not at this time

Energetic & Abundance Flow If yes, please share what feels present for you:*

Spiritual & Intuitive Awareness ReiAlign honors all belief systems and paths. Do you consider yourself intuitive, empathic, or energetically sensitive?*

Yes

Somewhat

Not sure

Prefer not to say

Do you have any spiritual or personal practices that support you (meditation, prayer, breathwork, journaling, etc.)?*

Medical & Wellness Awareness Reiki complements—but does not replace—medical care. Are you currently under medical care or taking prescribed medications?*

Yes

No

Prefer not to disclose

Medical & Wellness Awareness (If yes, you may briefly share anything relevant you feel comfortable noting.)

Session Preferences Would you like your session to focus more on:*

Deep Relaxation

Emotional Balance

Physical Comfort

Energetic Clearing

Overall Alignment & Integration

Is there anything you would like me to be aware of to best support you during your session?*

Consent & Understanding Please read and acknowledge the following:*

I understand that Reiki is a gentle, complementary energy practice and is not a substitute for medical or psychological treatment.

I consent to receiving Reiki energy healing with openness and personal responsibility for my well‑being.

I understand that experiences during Reiki sessions vary and may continue unfolding after the session.

Signature (typed):*

Date:*

Sacred Listening Agreement & Confidentiality Understanding

Name*

Last name

Email*

Phone Number

Sacred Listening Agreement. Sessions at ReiAlign are offered as a compassionate, confidential space for emotional expression, reflection, and release. I understand that this service is not therapy, counseling, legal advice, or crisis intervention. Reisha serves solely as an empathic listener and supportive presence. All information shared during Sacred Listening sessions is held in confidence and treated with respect and care. Exception to Confidentiality: If information is disclosed that involves intent to harm oneself or others, or confession of an active or planned illegal act connected to a crime, ReiAlign is legally obligated to report such information to the appropriate authorities. I acknowledge that Sacred Listening is intended for emotional release and self-reflection only and does not replace professional mental health, medical, or legal support. By proceeding, I confirm my understanding and agreement with the above.*

I understand and agree to the Sacred Listening Agreement

Sign Name*

Date*

Contacts

energycare@reialign.space

832.923.2799

Houston, TX

Opening hours

Appointment Schedule Available Upon Booking

Reiki Session Preparation & Energy Alignment Form

Sacred Listening Agreement & Confidentiality Understanding

Contacts

Houston, TX

Opening hours

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