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Full Name

Email Address

Phone Number

D.O.B

Address

Which Reiki course are you registering for?

Are you currently experiencing significant mental stress (e.g., anxiety, depression, recent trauma, high stress levels)?

Yes
No
Prefer not to say

Do you have any existing chronic physical health conditions (e.g., heart condition, severe chronic pain, mobility issues, recent surgery)?

Yes
No
Prefer not to say

If you answered 'Yes' above, please briefly elaborate on how this might affect your participation or what support you might need.

full-day (e.g., Which

If you answered 'Yes' to any health-related issue, please provide details, including any medication you are comfortable sharing, thay may impact your ability to attend or participate in a full-day course.

Are you currently pregnant?

Yes
No

What is your current work status?

Which days of the week are you generally available for a course?

What is your preferred time slot for the course?

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