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Reikinetics Pre-Session Check-In for 25-min Live Session+ Debrief

Please take 5 minutes to focus on yourself and answer the following before our next session.

Name:

*

Email:

*

Phone Number:

*

Preferred session date/time (or list availability):

*

Describe any recurring physical sensations or emotions you’ve noticed in the last week.

*

On a scale of 1–10, how intense is your current stress?

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0

1

2

3

4

5

6

7

8

9

10

What’s drawing you to this session? (Choose as many as apply or write your own).

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A

Stress or emotional overload

B

Feeling blocked, stuck, or ungrounded

C

Physical tension or pain

D

Intuition feels clouded

E

A need for clarity or reset

F

I’m not sure — just know I need something

G

Other:

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What was happening when you last felt "off" or stressed—work, family, self-care, other?

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What’s currently taking up the most space in your inner world? (This can be a thought, relationship, pattern, energy — anything you’re aware of.)

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What would relief feel like for you right now? (Emotionally, physically, energetically — describe it however you like.)

*

Is there anything else you'd like me to know before we begin?

*

After your session, you'll receive: ✓ 3 personalized energetic blocks I noticed
✓ 3 daily micro-rituals tailored for you in a printable PDF
✓ A 10-minute debrief to help you integrate