Animal Paradise - Communication & Healing
The Underground Peace Movement
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    Reiki Session Form
Please Contact Janet to see if she is available for appointments at this time before you fill out the session form: 

Reiki sessions are by appointment

Reiki Session Form


Zip Code:
Email Address:
Home Phone:
Work Phone:
Mobile Phone:
Your Time Zone   EasternCentralMountainPacificOther

Reffered by; or How You Learned About Animal Paradise:


 Your Animal's Name:




 Animal's age:


 Your Animal's Gender:

 Your Animal's Approx. Weight:


 Number of Years You Have Had Animal:


Where Did You Get Your Animal Companion; Shelter, Breeder, Friend, etc.:


Has Your Animal Been Spayed or Neutered


What Would You Like to Focus on In This Session Or What is the Nature of the Problem?:

 Have you or your animal Companion ever had a Reiki session? YesNo
 Have you taken a Reiki workshop or are you a Reiki practitioner? YesNo
Please enter numbers into the box on the right: *  

Privacy is important to me; therefore, I will not sell, rent, or give your name or address to anyone, ever!


Animal Communication is not a substitute for good veterinarian care. Only a licensed veterinarian can legally diagnose and prescribe medicines. Each states laws vary. Please consult your veterinarian for any health care concern. 

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