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Modern Mystics Intake Form

Date
Month
Day
Year
Birthday
Month
Day
Year
Who do I have to thank for your interest in Modern Mystics Reiki?
Have you had a reiki session before ?
Do you prefer any extra supports on the reiki table?
Do you prefer more verbal communication during the session, or more silence?
Are you under the care of a doctor
Do you have/had any of the following?

Please read and agree to the Waiver and Consent Form

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