As a patient you should be prepared to lie down or sit. Also patients should not wear uncomfortable clothing such as tight panty hose, corsets, and so on. Shoes, glasses, heavy jewelry, and jackets or coats should be taken off during a session. The patient does not need to take off his or her clothing other than these particularly restrictive garments. The patient should try to relax as much as possible before the session and during the treatment. Relaxation will help the Ki flow smoother.

The practitioner should provide a place for the patient to sit or lie down comfortably. Most patients prefer to lie down because it is more relaxing. Usually let the patient lie on their back first and work on the front of the body before moving to the back. Always start at the head and move downward to the feet. The positions for placing your hands on the patient's body are similar to the positions used on yourself. The differences are the private parts. Make sure you do not touch a patient in places that are private. You can still work on these areas by holding the palms a few inches from the body over the area.

First, the practitioner should relax, stand in horse stance or sit in sieza, and breathe deeply. Also, an exercise such as the dry bath exercise is a good idea. You want to be clear of outside influencing thoughts. You should be relaxed and be ready to let Reiki energy flow through you. Practitioners need to be centered and have healthy Ki vibrations in their own body before trying to practice Reiki on a patient. Being grounded and centered with clarity in your mind will allow you to connect to that universal energy that is always all around you. Once you are relaxed and centered, set your intention. Your intention is most important. You cannot have your own agenda but you also must have good intentions. Finally, you are ready to let the energy flow.

One way to begin a session is to give Reiki to the patient's head. Start with the crown, then the sides of the head where the temples are, and at last the forehead and back of the head. Once you have worked on a patient's head for 5-10 minutes you can try to intuitively let your hands be guided to where the patient needs Reiki. If the patient just wants a full body treatment then start at the head and move down the patient's body toward the hara. If the patient has back problems you may want to have him or her roll over so that you can treat the back. However, Reiki can treat most every part of the body by working on the patient while lying on the back. Once you have treated the front of the torso, then move to the shoulders and move down each arm. Last, treat each leg one at a time from the hips, to the knees, and to the ankles. End with the feet and the soles. It is good to end by giving Reiki to the bottoms of both feet for a few minutes, then connecting by giving Reiki to the crown chakra. Another closing procedure is to sweep your hands across the patient's aura without touching the patient. This sweeping should be done to the entire body from head to feet to smooth out the energy. Finally, shake off your hands and arms, give thanks for Reiki, bring your hands into gassho, and center your own body. It may be a good idea to do the dry bath exercise or a similar exercise to disconnect your body from the patient's energy. Sessions can be any length of time but at least a half hour is advised. Most people do not want to lie down and receive healing for more than an hour and a half, so that would be the maximum length of a session.