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* 1. What is your first and last name

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* 2. How did you hear about us?

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* 3. Have you experienced Reiki before?

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* 4. What is the main reason for scheduling this session?

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* 5. What day and time preferences do you have for the session (check all days and times you are available)

  Morning (7am -10am) Late Afternoon (3pm-5pm) Evening (5:30pm or later)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

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* 6. What is your favorite essential oil to smell (to be used in the diffuser for your session).

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* 7. What describes you best

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* 8. Which would you prefer to listen to during your session?

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* 9. Let us know how you feel about the following:

  Please use when possible No preference I'd prefer you don't use
Heated blanket
Weighted blanket
Reflexology
Vibration mat
Guided meditation or visualization
Affirmations and/or mantras
Crystal bowls or koshi chimes 

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* 10. If there is somewhere you prefer not to be touched (other than the obvious), or anything else that would be good for us to know - please tell us here. For example, if you are extremely ticklish on your feet etc.

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