To help me serve you better, please fill out and submit BOTH forms below. 

The New Client Information Form AND the Liability Release Form below. 

PLEASE NOTE: there are 2 separate "SUBMIT" buttons to click on, one for each form.

PLEASE fill out and submit BOTH FORMS on this page.   

   By providing me with some pertinent information now,  I will be better able to prepare for your session.  

This will allow me to offer you the highest quality of service, from your very first session.  ~ Thank You, Toni

PRIVACY NOTICE: 

No information about any client will be discussed or shared with any third party

without the written consent of the client (or parent/guardian if the client is under 18). 
 

DISCLAIMER:  PLEASE READ AND THEN ELECTRONICALLY SIGN, DATE & SUBMIT BELOW:
 
I understand that Energy Medicine and Massage are forms of Alternative/Complementary Medicine.  I understand that

Reiki, Rising Star, Prema Agni & Prema Birthing are all forms of Energy Medicine and are simple, gentle, hands-on energy techniques that are used for stress reduction and relaxation.  I understand that neither Energy Medicine Practitioners or Massage Therapists are able to diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, or interfere with the treatment of a licensed medical professional.  I understand that Energy Medicine/Massage Therapy does not take the place of medical care.  It is recommended that I see a Licensed Physician or Licensed Health Care Professional for any physical or psychological aliment I may have.  I understand that Energy Medicine can complement any medical or psychological care I may be receiving.  I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial.  I acknowledge that long term imbalances in the body sometimes require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself.   
 

BY SUBMITTING THIS FORM WITH YOUR NAME AND DATE FILLED IN BELOW, YOU ACKNOWLEDGE THAT YOU HAVE READ

AND UNDERSTAND THE DISCLAIMER AS WRITTEN ABOVE.
 

New Client Forms