New Client Intake Form

Reiki & Access Bars® New Client

Consent Form

***Please read this before signing the Intake Form***

I hereby voluntarily request and consent to receive Reiki and/or Access Bars® services from Michelle Cardenas, Reiki Master/Teacher & Access Bars Practitioner.

I understand and acknowledge that no guarantees have been made to me as to the effect of such services. I further understand and acknowledge that in no way are these services meant to be

interpreted by me as a diagnosis or treatment of disease, illness or condition. I understand that Reiki and Access Bars® can be an aid to balancing my energy, reducing stress, and to possibly improving my general health and wellbeing.

I understand that prior to my first Reiki and/or Access Bars® session I will receive an oral explanation and description of a Reiki/Access Bars® session. I understand that I may refuse any and all services at any time during my first session or during any subsequent sessions.

I understand that Michelle Cardenas, Reiki Master upholds the highest standards of care and professionalism. As an IARP® Registered Reiki Professional, Michelle Cardenas abides by the IARP Code of Ethics. A copy is available for review.

I understand that Reiki and Access Bars® are complimentary to but not a substitute for medical treatment or medications, and it is recommended that I concurrently work with my doctor or Primary Caregiver for any condition I may have. I am advised that if I am sick, I should consult my doctor. I am aware that my Reiki Practitioner does not diagnose illness or disease and does not prescribe medication.

If I experience any discomfort during the session, I will immediately communicate that to the practitioner so the treatment can be adjusted.

I understand that anything discussed and/or experienced before during or after care, while in treatment with Michelle Cardenas will remain confidential, according to the HIPPA Act. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge.

Please read this before signing the Intake Form - By signing the Intake Form you are acknowledging that you have read and understand the Consent information given here