Dharma Reiki & Acupuncture
Reiki Distance Healing Request and Informed Consent

Please fill out and submit this form. Don't hesitate to reach out to us if you have any questions.

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Distance Healing Policy

Informed consent to receive Holy Fire® Reiki distance healing. Please read and check the box to affirm your consent.
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Distance healing must be prepaid. No refund for payment once healing is sent. If healing is canceled before the prepaid duration of service is completed, we will issue a refund for the remaining days.
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The submitter must be at least 18 years of age to request and consent to receiving Holy Fire® Reiki distance healing
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Privacy Notice and Consent for Electronic Submission of Form
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