A Balanced Life Reiki Waiver Form
Instructor: Taralee Trammell

1. Participant Information:
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  • 2. Nature of the Service

    I understand that Reiki is a complementary energy-based relaxation practice in which the Practitioner places their hands lightly on or slightly above the body. I will remain fully clothed throughout the session and will typically be seated or lying on a treatment table. I understand that Reiki is not massage, chiropractic, physical therapy, or any form of licensed medical or mental health care.
  • 2. Assumption of Risk

    I understand that responses to Reiki vary from person to person and may include sensations of warmth, tingling, or coolness; deep relaxation or drowsiness; lightheadedness upon standing; temporary fatigue; emotional release such as crying or resurfacing memories; or a temporary increase in awareness of existing symptoms as the body responds. I also understand there is an inherent risk in getting on and off a treatment table. I voluntarily participate with full knowledge of these possibilities and assume responsibility for any discomfort, loss, or injury I may sustain.
  • 3. Health Representation & Personal Responsibility

    I represent that I know of no condition that would prevent my safe participation. I understand the Practitioner is not a licensed medical or mental health professional and does not diagnose conditions, prescribe or adjust medications, perform medical treatment, or promise any specific outcome. Reiki is not a substitute for medical, psychiatric, or psychological care, and I agree to continue any treatment prescribed by my healthcare providers. I agree to disclose any injury, illness, pregnancy, recent surgery, mental health condition, or physical limitation before my session, and to tell the Practitioner at any point if I become uncomfortable.
  • 4. Consent to Touch

    I consent to light, non-invasive touch on areas such as the head, shoulders, arms, torso, legs, and feet. I understand that no touch will occur on the breasts, genitals, or buttocks, and that draping and modesty will be respected at all times. I understand that I may request a hands-off (hovering) session, ask that specific areas be avoided, or end the session at any point, for any reason, without explanation.
  • 5. Release and Waiver of Liability

    In consideration of being permitted to receive services, I, on behalf of myself and my heirs, assigns, and personal representatives, hereby release, waive, and discharge Taralee Trammell and A Balanced Life, and the owners of any facility where sessions are held, from any and all claims, demands, or causes of action arising out of any loss, damage, or injury sustained while receiving Reiki services or while on the premises, whether caused by negligence or otherwise, to the fullest extent permitted by law.
  • Authorized Signature for Company