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Your Consultation Form

Please take a few moments to complete the consultation form below.

The information you provide will help design and deliver a truly bespoke healing experience that's fully personalised and deeply nurturing. Once complete, you will be taken to the secure booking page to finalise your appointment.

Please take a few peaceful moments to complete your consultation form, so your healing experience can be fully personalised and deeply nurturing.

First name

Last name

Address

Email

Phone

Birthday

Month

Day

Year

Your next of kin contact information (for emergencie use only)

Name, address and contact number of GP? (for referral and emergencie use only)

Do you experience any of the following?

Unhealed fractures, spinal injuries, muscle tears, or any restriction in movement.

Open wounds, skin or hair infections, including contagious infections.

Symptoms of COVID-19 or any other respiratory symptoms/illness.

Have certain untreated or active health conditions (e.g., cancer, diabetes, epilepsy, mental health or high/low blood pressure heart disease or hyper/hypo tension etc) with or without a medical clearance letter.

Are you under the influence of drugs or alcohol.

Allergies or sensitive to essential/massage oils balms or incesnse.

Are you sensitive to touch?

Have you experienced Reiki Energy Heaaling before?

If you have answered YES to any of the above, please provide further health or wellbeing information below.

Is there anthing else relating to your health and wellbeing we need to be made aware of, so your healing experience can be fully personalised and deeply nurturing.

What would you like your Reiki healing session to help you with and focus on?

I confirm the information provided on this form is accurate and true and agree to pay the full payment of either £50 or £40 to secure my appointment at Setmore and payment via Squareup on submission of my consultation form. I also acknowledge that I have read and/or been given the opportunity to read and agree to the current published booking, privacy and accessibilit policy.

Please sign your consultation form before submitting.

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Wellbeing Treatments

Reiki Massage (Lower Body)

THE ROOTED MAN

Whether you're navigating the pressures of modern life, seeking reconnection with yourself, or simply in need of deep rest, this treatment will leave you feeling grounded, balanced, and emotionally clear, with a renewed sense of calm that lingers long after the session ends.

Explore Treatment

Reiki Healing Energy Treatment (Whole Body)

RISE REIKI ENERGY

Reiki offers a non-invasive and deeply relaxing way to reconnect with their physical and emotional wellbeing, helping to release tension, improve focus, and manage anxiety or burnout. Following your treatment, you will leave feeling grounded, balanced, and emotionally clear, with a renewed sense of calm that lasts long after the session ends.

Explore Treatment

Manage Your Current Appointment

MANAGE APPOINTMENT

Securely manage and change your current appointment online via your client account.

Click the link below to access your account.

Visit Squareup Account

SCHEDULE APPOINTMENT