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Animal Reiki consent
Intake and consent for Reiki and energy work with your animal companion.
← All forms
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Do you want Rocksteady Life to contact you after your Pet's session to check in?
*
No
Yes
Pet's name
*
Type/Breed
*
(Cat, Dog, Fish, Bird, etc)
Pet's age
*
Caregiver's name
*
First
Last
Caregiver's email
*
Email
Confirm Email
Phone
*
Preferred contact method (select all that apply)
*
Email
Text
Phone call
Has your pet ever had a Reiki session before?
*
No
Yes
to When Today's
When was their last session?
Number of previous sessions (if known)
Other services
Reiki for yourself (caretaker)
Companion Reiki (Reiki for the caretaker and pet at the same time)
End of Life/Transition services
Multiple pets
Distance Reiki (via Zoom, phone call or at a pre-arranged time)
In-person sessions
Select all that apply.
What would you like me to know about your pet and their situation?
*
Name
*
First
Middle
Last
Today's date
*
Website
Submit
