Animal Paradise - Communication & Healing
The Underground Peace Movement
Your Subtitle text

    Reiki Session Form
Please Contact Janet to see if she is available for appointments at this time before you fill out the session form: janet@animalparadisecommunication.com 

Reiki sessions are by appointment

Reiki Session Form

Name:

 Address:  
City:
State:
Zip Code:
Country:
Email Address:
Home Phone:
Work Phone:
Mobile Phone:
Your Time Zone   EasternCentralMountainPacificOther

Reffered by; or How You Learned About Animal Paradise:

 

 Your Animal's Name:

 

 Breed:

 

 Animal's age:

 

 Your Animal's Gender:

 Your Animal's Approx. Weight:

 

 Number of Years You Have Had Animal:

 

Where Did You Get Your Animal Companion; Shelter, Breeder, Friend, etc.:

 

Has Your Animal Been Spayed or Neutered

 YesNo

What Would You Like to Focus on In This Session Or What is the Nature of the Problem?:

 
 Have you or your animal Companion ever had a Reiki session? YesNo
 Have you taken a Reiki workshop or are you a Reiki practitioner? YesNo
Please enter numbers into the box on the right: *  


Privacy is important to me; therefore, I will not sell, rent, or give your name or address to anyone, ever!

 **Disclaimer 


Animal Communication is not a substitute for good veterinarian care. Only a licensed veterinarian can legally diagnose and prescribe medicines. Each states laws vary. Please consult your veterinarian for any health care concern. 

Website Builder