
AWC Reiki Healing Waiver
Informed Consent for Reiki Treatment:
Assumption of Risk and Release of Liability Waiver
• I understand that Jeff Sera offer a Reiki session, involving a natural hands-on method of energy balancing for the purpose of pain management, stress reduction, relaxation, and to promote health and wellness.
• I understand very clearly that these treatments are not intended as a substitute for medical or psychological care.
• I understand that Jeff Sera is not a: massage therapists, chiropractic doctors, registered nurses, registered dietitians, nor medical doctors.
• I understand, Jeff Sera is not qualified to diagnose, treat, cure, prevent or assess any disease, disorder or condition.
• I understand, Jeff Sera is not qualified to prescribe medication or dietary alternatives. If I need medical attention or care, I know full well that I will seek medical care elsewhere with a licensed physician.
• I understand that Reiki does not promise any form or level of cure for any specific (or otherwise) condition.
• I have informed Jeff Sera of all my known physical and medical conditions, and I will keep the practitioner updated of any changes.
• I understand that I may feel a slight change of temperature in areas where hands are place and possible minor discomfort, due to healing properties but will receive a state of relaxation from the process.
• I understand that I may be consumed with emotions during session which is common for some clients to encounter.
• I understand and acknowledge that by receiving Reiki treatment from Jeff Sera (FOOD 4 THOUGHT 408 LLC), the risks may include, but are not limited to: emotional release, lightheadedness, mild fatigue, physical tingling, and change in body temperature. I voluntarily assume and accept all the aforementioned risks and all other risks myself.
• I understand that I may discontinue a session or sessions at any time.
• I consent and understand that I am willing to receive Reiki treatment and agree to the terms above.
Client Signature
I HAVE CAREFULLY READ THIS AGREEMENT AND AGREE TO THE TERMS OUTLINED ABOVE. I UNDERSTAND THIS AGREEMENT TO BE A FULL AND FINAL RELEASE OF ALL COSTS, CLAIMS, CAUSES OF ACTION AND DAMAGES OF ANY KIND ARISING FROM OR IN CONNECTION WITH REIKI OR FOOD 4 THOUGHT 408 LLC SERVICES, PROVIDED BY JEFFREY SERA AND ASSOCIATED HEALING PRACTITIONERS
In that spirit, by scheduling a Reiki session with Jeffrey Sera and Associated Healing Practitioners, via Food 4 Thought 408 LLC, I confirm that I have read and agreed to each statement and that I wish to proceed:
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