Reiki intake form: Free template and consent guide

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Key takeaways

A reiki intake form captures personal details, emergency contacts, health history, medications, previous reiki experience, session goals, and a signed consent statement.

Because reiki is unlicensed in most US states, the consent wording is the only written record of your scope of practice.

Ask only what changes how you run the session, since surplus health data adds privacy risk without adding clinical value.

Health answers matter most for clients on blood thinners, in recent surgery recovery, or in acute mental health distress.

Online forms sent before arrival remove the clipboard, the retyping, and the filing cabinet that paper intake still needs.

A reiki intake form is the questionnaire a client completes before their first session, covering health history, medications, previous reiki, and signed consent. It is the one document that records what the client told you, and what you told them.

Reiki sits outside medical licensing in most places. That record is your main protection if a client later claims you promised a cure.

It also shapes the session itself. A first-timer on blood thinners needs a different brief from a monthly regular. Start with the template below, then use the rest of this guide to check what each section asks.

What a reiki intake form does before the session starts

The form does three jobs in about five minutes of the client’s time. It tells you what is going on in their body. It records that they understand what reiki is and is not. And it leaves a baseline you can compare against six sessions later.

None of that is unique to energy work. A spa intake form template asks many of the same questions. Reading one is a fast way to see the shape before you adapt it for reiki.

What is unique is the session-history question. Someone who has had 20 sessions needs no explanation of what will happen. Someone on their first needs two minutes on what to expect, including the tiredness some people report afterward.

Why the form matters more when reiki is unlicensed

In most US states reiki has no license, no board, and no scope defined in statute. Massage regulations catch it in a handful of states, but nowhere near all. In the UK, registration with the Complementary and Natural Healthcare Council is voluntary.

That absence changes what the form is for. A licensed therapist has a board-defined scope behind them. You have the paragraph the client signed. If a dispute ever reaches a complaint or an insurer, the consent wording is the document that describes what you offered.

So the consent paragraph deserves as much attention as the health questions above it. Those questions keep the session safe. The consent keeps the boundary visible.

What to include, section by section

Here is the whole form at a glance, before we go through the sections one at a time.

Personal details and two emergency contacts

Name, date of birth, gender, address, phone, and email cover the basics. The template also asks for two emergency contacts rather than one, each with a relationship and a number.

Health history, medications, and their physician

Ask for current diagnoses, past and present injuries, surgeries, and every medication or supplement. The template also leaves room for the client’s primary care physician, which helps when you need to suggest they check something with a doctor.

Three answers should slow you down: blood thinners, surgery in the last few weeks, and acute mental health distress. None of them rules reiki out. They change how long you work, how firmly you rest your hands, and what you say afterward.

Previous reiki and what they want from this session

Two questions do a lot of work here. Ask whether they have had reiki before, and how recently. Then ask what they want from today, in their own words.

A client writing “sleep” needs a different session from one writing “I want to feel something.” That second answer also tells you whether to manage expectations before you begin.

Where emotional and stress questions fit

The downloadable template has no dedicated mental health section. It captures this under “other relevant information,” which suits practitioners who would rather ask in conversation.

If you prefer a written answer, add two short questions of your own: current stress level, and any recent loss or upheaval. Keep it brief, since a reiki intake form is not a mental health assessment, and collecting more than you need creates a duty to protect it.

The four sentences your consent section needs

The template’s consent block covers four points, and each one is doing a specific job:

• No diagnosis, treatment, or prescribing. Reiki practitioners do not diagnose or interfere with medical care. This scope statement is the sentence that matters most.
• Reiki does not replace a licensed professional. This closes off any later claim that you told a client to skip their doctor.
• The client has disclosed known conditions. They also agree to flag changes during the session, which puts part of the duty back on them.
• A liability release. The practitioner cannot be held liable for problems attributed to the session.

Underneath all four sits a signature and a date. Without a signature you have a questionnaire and no consent. Check for it before the client lies down.

What to leave off the form

Most guidance tells you what to add. The more useful question for a solo practitioner is what to leave out.

You are holding health data without a compliance department behind you, so every extra field is a small liability with no clinical payoff.

• Social security or national insurance numbers. You are not billing insurance, so there is no reason to hold one.
• Diagnostic histories going back decades. Current conditions and recent surgery are what change the session.
• Photographs of the client. A reiki session needs none, and images raise the sensitivity of the whole record.
• Card details written on paper. Take payment through your booking system instead.
• Free-text boxes with no prompt. Clients either leave them blank or write things you then have to store.

The test is simple. If an answer would not change how you run the session, or who you would call in an emergency, leave the question off.

How to store what you collect without breaking privacy rules

Once a client fills the form in, you are holding health data, and the rules depend on where you practice. In the US, HHS HIPAA guidance sets the standard for entities that handle health information.

Most solo reiki practitioners are not covered entities, because they do not bill insurance electronically. Following the same principles is still sensible. Use encryption, access control, and a locked drawer for anything on paper.

In the UK and the EU, GDPR applies whether you are registered anywhere or not. ICO guidance on the UK GDPR treats health information as a special category.

That means you need a lawful basis for holding it and a set retention period. You also need a way to answer a client who asks to see their record.

Write the retention period on the form itself. It saves an awkward conversation later.

Paper, email, or online: Which one fits your practice

Three routes are available, and the right one depends on how many new clients you see in a month:

• Seeing one or two new clients a month? Paper is fine. Print the PDF, keep a folder, and lock it.
• Emailing the PDF back and forth? This is the route worth dropping. The form lands in a personal inbox with no backup and no access control, which makes it the weakest of the three.
• Booking more than a handful a week? Send a link instead. The client fills it in on their phone before arrival, and the answers land in their record already typed.

Reiki practitioners working inside a day spa often have this already, because the front desk’s spa software carries forms alongside the calendar.

Working alone, digital intake form software does the same job without the rest of the platform.

How Pabau collects and stores your client intake forms

Right now the routine probably looks like this. You print the PDF, hand it over on a clipboard, and file the paper afterward. A week later you are flipping through the folder to remember whether a returning client mentioned a back injury.

Practice management software like Pabau replaces that loop. You build the intake form once in the form builder, matching the five sections above. Pabau sends it as a link when the client books. They complete it on their phone, and the answers save straight into their record.

The signature is captured on screen, so consent and questionnaire stay together in one file. Clients can go back into the client portal to update medications before their next visit, which saves you asking. Records sit behind encryption and role-based access, which covers the storage question above.

The same setup runs the rest of a wellness business. Pabau’s wellness clinic software keeps intake, bookings, notes, and payments in one place as you add practitioners.

Ready to go digital with your reiki intake forms?

Pabau makes it simple to collect, organize, and secure client information in one encrypted platform. Book a demo to see how practitioners like you streamline client onboarding and compliance.

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Conclusion

Download the template, use it on your next new client, and then change it. The version that works for your practice is the one shaped by the questions you keep having to ask out loud.

Weigh thoroughness against exposure. A longer form feels more professional, but every field you add is health data you now have to protect. Ask what changes the session, and stop there.

If you are still filling in the same paper form by hand each week, that is the part to change first. Book a demo to see how Pabau sends the intake form before the session and files the signed consent for you.

Continue your research

Running massage alongside reiki? Massage intake form covers the pressure, posture and contraindication questions that bodywork needs on top of the basics.

Want a plan the client leaves with? Personal wellness plan turns session goals into something written down and reviewable at the next appointment.

Adding another modality to your studio? Holotropic breathwork guide sets out the screening and safety steps for a practice that draws a similar client.

Working with hands-on energy techniques? Hand reflexology charts give you a printable reference for mapping points during a session.

Frequently asked questions