Infrared Sauna Consent Form

Permission to use the far infrared sauna is contingent on guests providing accurate answers to the questions below so that we can mutually agree on the health and well-being of the sauna user, as well as signing this agreement.

Name

First Last

Date Of Birth

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone number

How did you hear about us?

If referral we'd love to thank them

Please answer the following questions yes or no

Are you pregnant? How far along?

Are you taking any medications?

Have you been diagnosed with any medical condition, such as anhidrosis, that may limit or prevent your ability to sweat?

Do you have unstable angina?

Have you had a recent heart attack?

Do you have Peripheral Artery Disease?

Have you been diagnosed with any other medical condition? If “yes,” which condition?

If you answered “yes” to any of the above questions; have you consulted with your medical provider about using a far infrared sauna?

It is always important to maintain proper hydration levels during far infrared therapy. Dehydration will increase carbohydrate utilization and cause less fat to be burned for energy. We highly recommend drinking a minimum of 8 oz. of water prior to entering the sauna and a minimum of 8 oz. of water after sauna use.

INFRARED SAUNA AGREEMENT/ACKNOWLEDGEMENT

1. The use of drugs, medication or alcohol prior to or during the far infrared sauna session may lead to dizziness or unconsciousness. Clients using any medications must consult a physician or pharmacist prior to the use of the sauna.

2. Please consult your physician if you are in doubt of your ability to use the far infrared sauna for health reasons.

3. No one under the age of 18 is permitted in the far infrared sauna unless accompanied by a supervising adult.

4. Discontinue the use of the sauna if you feel light-headed, dizzy, or heat exhausted.

5. Sauna sessions should be limited to no more than 45 minutes and temperatures must stay below 150 degrees Fahrenheit.

6. Plastic water bottles are not permitted in the sauna.

7. Pregnant women should consult their physician prior to the use of the sauna. Excessive body temperatures have the potential to cause fetal damage during the early days of pregnancy.

I acknowledge and voluntarily assume the risk of injury, accident, or death that may arise from the use of an infrared sauna. I, on behalf of myself and any of my heirs, executors, representatives, or assignees, hereby waive and release all claims or liabilities for personal injury or property damages of any kind sustained while on the premises, during the use of the far infrared sauna and from any advice provided by an employee, independent contractor, or any representative. I agree that this Application and Waiver is in effect for all infrared sauna sessions and will not expire unless specifically requested by either party.

Signature

Date