INTERNATIONAL  REIKI  INSTITUTE  

3, IMPASSE SIMONET,  JERNINGAM STREET, CUREPIPE ROAD,  

REPUBLIC OF MAURITIUS. 

Tel. 6702837, 6751708  

Distance Healing: Agreement for Services  

The Distance healing services offered by International Reiki Institute is for bio-feedback and bio-resonance therapy.  It is sometimes referred to as Vibrational Medicine or Energy Medicine.  However, the services offered by our centers are not connected with traditional medicine as practiced by most western medical doctors and hospitals.  Traditional medicine is based on biochemistry.  Energy Medicine is concerned with biophysics.  It is an entirely separate discipline concerned with the correction of energy fields, and with balancing the CHAKRAS or bio-electric frequencies of the human system. 

I agree to undergo Reiki Distance Healing at my own risk.  I further indemnify and hold harmless “INTERNATIONAL REIKI INSTITUTE” Anil Kumar Proag and/or his affiliates, officers, as well as, any successors, assigns and executors, administrators, personal representatives, employees and heirs from any and all results of Reiki Distance Healing therapy or any other modality I receive from INTERNATIONAL REIKI INSTITUTE Healing program, including biofeedback, bio-resonance and/or other healing instruments. 

This agreement shall be unlimited as to amount of duration, and it shall be binding upon to the benefit of the parties, their successors, assigns and personal agents and representatives.   

INTERNATIONAL REIKI INSTITUTE or its personnel do not diagnose, treat, prescribe or claim to cure any disease. 

Clients are advised that they should consult their own medical practitioners and medical professional for the diagnoses, care, treatment or cure of any health condition. 

However, it is the intent of the INTERNATIONAL REIKI INSTITUTE to promote self-healing through information, biofeedback, Reiki Distance healing frequencies and emotional support. 

I understand that there are many kinds of healing that can include emotional, spiritual, and/or physical healing. I understand that healing is not bound by particular time periods. 

Booked appointments will be charged unless cancelled within 24 hours. (Unattended therapy will be at the discretion of the therapist.) 

I am of legal age or have the agreement of my parent or legal guardian to seek the services of INTERNATIONAL REIKI INSTITUTE 

I am of sound mind and able to make decisions about my own health. 

1.) I have read and agree to the fore-going; 2.) That the procedure set forth above has been adequately explained to me by this provider, and 3.) That I authorize and consent to the performance of the foregoing services. 

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Signature                                                           Date                  credit card w/ Expiration Date _____/____    

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