TERMS & POLICIES

We reserve the right to revise the terms and conditions and prices at our discretion by updating this website.  Therefore, you should periodically visit this page to review the current Terms and Policies.

 

As a Complementary and Alternative Health Care Practitioner, I am not licensed, certified, or registered by the state of Colorado as a health care professional.  I am not a licensed medical physician and do not diagnose, treat, or prescribe remedies for the treatment of disease.

 

REIKI SERVICES DISCLOSURE

DISCLOSURE STATEMENT AS REQUIRED UNDER SB-215 FOR COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONERS IN COLORADO

1.  Crystal Chinn

2.  808-492-9955

As a Complementary and Alternative Health Care Practitioner, I am not licensed, certified or registered by the state of Colorado as a health care professional. I am not a licensed medical physician and do not diagnose, treat or prescribe remedies for the treatment of disease. The services I perform, whether in person, by mail or by phone, are at all times restricted to complementary and alternative health care services intended for the maintenance of the best possible state of general well-being. I am prohibited from performing surgery or any invasive procedure, administer or prescribe x-ray radiation, prescribe prescription drugs, use general or spinal anesthetics, administer ionizing radioactive substances, use a laser device that punctures the skin, perform enemas/colonics unless board certified, practice midwifery, practice psychotherapy, perform spinal manipulation, practice optometry, directly administer medical protocols to a pregnant woman or a person who has cancer, practice dentistry, set fractures, practice massage therapy, provide a conventional medical disease diagnosis or recommend the discontinuation of a course of care recommended by a health care professional.

Further, you understand the services I offer and the use of Reiki and Meditation are not intended to be a substitute for medical or psychological treatment and they do not replace the service of health care professionals. You agree and understand it is your responsibility to consult with your health care provider for any specific health care problems.

By signing this document you understand I am offering my services solely as a complementary and alternative health care practitioner and our relationship is not to be construed as medical treatment, psychotherapy, psychological counseling, or any type of therapy, nor is it a substitute for these services.

I am prohibited from treating children less than two years of age. In order to treat a child who is between 2-18 years of age, I must have a written, signed consent of the child's parent or legal guardian.

The services I, Crystal Chinn provide are as follows: Reiki Treatments, Distance Reiki, Reiki Classes.

My professional degrees, training, experience, credentials and qualifications are as follows:

I took the following Reiki classes with Tekla C Ayers, Usui Reiki and Karuna Master:

  • Usui Shiki Ryoho - First Degree Reiki (April 2019)

  • Usui Shiki Ryoho - Second Degree Reiki (January 2020)

  • Usui Shiki Ryoho - Advanced Reiki Training (August 2020)

  • Usui Shiki Ryoho - Reiki Master Training (February 2021)

I have been practicing in-person Reiki since April 2019 and Distance Reiki since January 2020.

I carry a liability insurance applicable to any injury caused by an act or omission in providing complementary and alternative health care services.

A copy of this disclosure statement will be kept on file for at least two years after the last date of service.

*As my client, you should discuss any recommendations I provide with your Primary Care Physician, Obstetrician, Gynecologist, Oncologist, Cardiologist, Pediatrician or Pediatric Health Care Provider, or other Board-Certified Physician.

I understand that Reiki is a simple, gentle, hands-on energy technique that is used for stress reduction and relaxation. I understand that Reiki practitioners do not diagnose conditions nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. I understand that Reiki 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 ailment I may have. I understand that Reiki 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 signing the form below, I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Crystal Chinn.  Full disclosures of the credentials and training background will be provided upon request. 

I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Thanks for submitting!

 

PARENTAL CONSENT

Consent to Treatment of Minor:

By submitting the form below, I agree to have read and fully understand and agree to the above terms of this Reiki Intake Form and authorize Crystal Chinn to administer Reiki to my child or dependent.

Thanks for submitting!