Name *

Email *

Phone *

Services Interested In

Check all that apply to you

Energy Balance
Relaxation
Anxiety
Emotional Balance
Spiritual Guidance
Other

Please add any personal information you'd like to share here, or questions you may have prior to your visit. Please advise of any specific ailments, sensitivities or special requests prior to your appointment in the space provided, below. *

The services offered by Lotus are a form of holistic, Japanese healing. By selecting that you accept the terms below, you are in full agreement and understanding that this practice is not promising the elimination of physical ailments, illness, emotional distress, or other reasons you're seeking treatment. Most times, clients find relief and a sense of peace, but we cannot make concrete promises.

Energy healing can be very powerful. After a session, clients should feel a relief of previous symptoms, and a sense of "lightness." In other instances, a client may feel temporary fatigue, light headedness, drowsiness or nausea. While this is rare, it is temporary and should subside within 24-48 hours. Please note, everyone's body processes a treatment different, so we cannot make concrete guarantees.

During an appointment, a client may also feel sudden surges of energy through their body. This may feel like but is not limited to the following: warm sensations, coolness, pressure or muscle spasms. This too, is temporary and very common during sessions.

Days following the appointment, you may feel a natural sense of calm and ease. You may also notice variable emotional upswings and downturns. Energy healing has the potential to draw out emotions we hold deep in our body. We are essentially like an onion, with many layers that are revealed to heal during energy healing sessions. These varied emotions are temporary and will pass. If anything feels unsettling, please contact your practitioner for feedback and support.

Best practices after receiving treatment are moderate rest. It's best not to do intense exercise or heavy lifting directly after an energy healing session, as you may feel a bit drowsy or weak. Drink plenty of water, too!

By submitting this form, you are not holding Lotus Reiki responsible for any temporary emotional or physical reactions during or after your treatment. This is because you are aware that they are temporary and a result of clearing and balancing your energetic field.

By submitting this form, you are also consenting to the practitioner placing their hands lightly on your body, diffusing oils via aroma therapy, the playing of sound frequencies, smoke cleansing, and the use of crystal therapy on and around the body.

I agree Terms and Conditions *

eSignature *

Home Address + An Emergency Contact *

Thank you for your interest in Lotus

We will review your information and get back to you soon!

Excited to start this journey -xoxo

Thank you for your interest in Lotus

We will review your information and get back to you soon!

Excited to start this journey -xoxo

Client Intake

Charmon 3 charm necklace

Charmon 3 charm necklace