I agree to be the recipient of Reiki and this session given to me by “The Reiki Therapist” This consent applies until revoked by me.
I understand that Reiki Therapy is a complementary, therapy which means that any therapy or treatment provided to me should be complementary with or in addition to a medical course of treatment or therapy administered under medical care.
The “The Reiki Therapist” does not offer diagnosis and any perceived diagnosis should not be relied on by me.. I should consult a registered medical practitioner for diagnosis. This includes if I have perceived that I have been diagnosed by “The Reiki Therapist”
I agree that “The Reiki Therapist” shall be excluded from liability in tort or negligence to the fullest extent permissible by law with respect to any harm which is not reasonably foreseeable by “The Reiki Therapist”
I understand that “The Reiki Therapist” is not responsible if therapy or treatment does not have the effect anticipated by me. Reiki may require more than one session to be effective however I understand that I am under no obligation to have more than one. If I choose to have any treatment (one session or more), that is in exercise of my own free will and at my own risk.
Providing there exists a specific and related medical diagnosis I understand that any Reiki treatment of any sensitive areas (such as breasts or genital regions shall be at the discretion of “The Reiki Therapist”. “The Reiki Therapist” will ask for my verbal permission before commencing Reiki treatment of those areas at which point (or at any time thereafter by verbal objection) I can refuse permission if I wish.
I agree that I will pay to “The Reiki Therapist” the full fee in respect of any consultation at the conclusion of each consultation.
I acknowledge that “The Reiki Therapist” can refuse service to any person(s) at any time at “The Reiki Therapist” discretion. Where possible “The Reiki Therapist” will refer me to another practitioner (if appropriate).
I state that all information provided is a true and accurate record.
PRIVACY OF INFORMATION
I authorize “The Reiki Therapist” to make notes and use information about me for the purpose of the Reiki business. Should “The Reiki Therapist” deem necessary.
“The Reiki Therapist” is not authorized to disclose any information about me without my written consent except as required by law, or for the purposes of debt collection, or when failure to do so could constitute a danger or menace to myself or any person(s).
The Privacy Act 1988 entitles me access to and if necessary to request correction of personal information that “The Reiki Therapist” holds about me.
I acknowledge by signing below that I have read and agree with/to the above consent/notice/disclaimer/privacy clauses in the event that I take issue with any clause above I should draw this objection to the attention of the Reiki Therapist immediately.