Frost and Float Spa LLC
New Client Waiver for Whole Body Cryotherapy and Infrared Sauna Terms and Agreement
Contraindications for WHOLE BODY CRYOTHERAPY:
Do not use Whole Body Cryotherapy if you have any of the following conditions:
- Uncontrolled high blood pressure
- Heart attack (previous six months) or conditions related to heart surgery
- Unstable Angina Pectoris or chest pain
- Disease of blood vessels
- History of blood clots
- Pacemaker, Valvular or Ischemic Heart Disease
- Bleeding disorders
- Peripheral Arterial Occlusive Disease
- Deep Vein Thrombosis (DVT) or known circulatory dysfunction
- Flu or Fever
- Cold Allergy
- Open Sores
- Nerve pain in feet or legs
- Recent Stroke/CVA
- Uncontrolled Seizures
- Symptomatic Lung Disorder
- Alcohol or drug related inebriation
- History of Fainting
- Raynaud’s Disease
- Acute kidney and urinary tract disease.
You may have other conditions that make whole body cryotherapy inappropriate. Consult with your doctor or medical advisor if you have questions as to whether whole body cryotherapy is right for you.
I acknowledge that I have read the above and do not have any of the listed contraindications.
Possible Risks of Cryotherapy:
- Fluctuations of blood pressure (increase 10 points systolic)
- Allergic reaction to cold
- Activation of latent viral conditions (i.e. cold sores)
- Restlessness at night (due to increased energy levels.
Waiver of Liability and Agreement for WHOLE BODY CRYOTHERAPY
1. In consideration for using the Cryosauna (Cryotherapy Equipment), I here by release, waive, and discharge in advance Frost and Float Spa LLC along with it’s staff from any and all liability, claims, demands, actions and causes of actions whatsoever arising out of or related to any damage or injury that may be sustained by me, while using the equipment or due to the use of the equipment.
1.2 I here by confirm that no warranty or guarantee, or other assurance has been made to me covering the results of the Whole Body Cryotherapy process. I have been explained and understand the administration of the process, including possible adverse reactions, side effects, or other possible complications. It is understood that this consent is being given in advance of any administration of the process, and is being given by me voluntarily to use the Cryotherapy Equipment.
2. I am fully aware of the risks connected with the use of the Cryotherapy Equipment, and I am voluntarily participating in said Equipment usage, and entering the above named premises to engage in such usage. I understand that the following risks and hazards may occur in connection with any particular treatment, including but not limited to: unsatisfactory results, allergic reaction, poor healing, discomfort, redness, scarring, infection, change in pigmentation, blistering, nerve damage, muscle damage and increased hair growth. I understand that even though precautions may be taken in my treatment, not all risks can be known in advance.
3. I furtherhere by agree to indemnify and hold harmless the release from any costs that may incur due to the use of the Equipment by me.
4. It is my expressed intent that this Agreement shall bind the members of my family and shall be deemed as a RELEASE, WAIVER, and DISCHARGE of Frost and Float Spa LLC. I hereby further agree that this Waiver of Liability shall be construed in accordance with laws of the State of Massachusetts.
5. I understand that the Equipment is designed for the fitness and appearance enhancing use of a person in good general health. I have been advised that if I suffer from any medical condition or illness whatsoever, I am NOT TO USE, the Equipment without my doctor’s written permission. If I should faint due to excess nitrogen inhalation, I hold myself responsible for all injuries should I fall, and the Frost and Float SPA LLC staff has the right to assist me. My signature below constitutes my acknowledgement that
5.1 I have read, understand, and fully agree to the foregoing CONSENT.
5.2 The proposed Whole Body Cryotherapy process has been satisfactorily explained to me and I have all of
the information that I desire. I understand that participation in a cryotherapy session involves exposure to extreme cold temperature for a short period of time (not to exceed three (3) minutes per session). I understand that a cryotherapy chamber technician will be present during my entire session and that I may not use any cryotherapy equipment without the technician present. I agree to follow all instructions given to me by the technician and to adhere to all of the rules and regulations prescribed by Frost and Float Spa LLC.
5.3 I hereby give my authorization and consent. This CONSENT shall stand as long as I use the Equipment at the location now and in the future.
IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read and understand the foregoing Waiver of Liability and Agreement, I am at least (18) years of age and fully competent; and I execute this Release for full, adequate, and complete consideration fully intending to be bound by same. Furthermore, I agree that I will comply with all instructions on the use of the Cryotherapy equipment and that I am using these services at my own risk. I agree to use all sessions within terms of the contract dates and understand that refunds are not given on unused portions of purchased packages. By signing below, I affirm that I have read and fully understand the risks as outlined in this waiver. I VOLUNTARILY AGREE TO EAC OF THE TERMS AND PROVISIONS HEREIN AND SIGN THIS OF MY OWN FREE WILL.
Client or Parent/Guardian Name (Print) :
Contraindications for INFRARED SAUNA:
- Uncontrolled High Blood Pressure
- Congestive Heart Failure
- Intoxication due to increased consumption of alcohol
- Multiple Sclerosis
- Central Nervous System Tumor or Diabetic Nueropathy
- Joint Injury (past 48 hours) that is still swollen
- Recent wounds from operation or surgery
If you have experienced any of the above contradictions, you must get a release form from your physician before using the Infrared Sauna.
I acknowledge that I have read the above and do not have any of the listed contraindications.
We ask that you are extra cautious when using the Infrared Sauna if…
- You are currently taking diuretics, barbiturates, beta-blockers or anti-histamines.
- You are under the age of 16 or over the age of 65.
- You are currently having a heavy menstrual period.
- You have metal pins, rods, artificial joints or other surgical implants.
- You have a hard time breaking sweat.
You can lower the sauna panels off of you at any time to cool off. We can set your sauna bed to a lower temperature. Step out of the infrared sauna immediately if you experience dizziness or are sleepy. In the rare event, you experience pain and/or discomfort, immediately discontinue sauna use.
Information on Contraindications and Cautions for INFRARED SAUNA:
Individuals with cardiovascular conditions or problems (hypertension / hypotension), congestive heart failure, impaired coronary circulation or those who are taking medications, which might affect blood pressure, should exercise extreme caution when exposed to prolonged heat. Heat stress increases cardiac output, blood flow, in an effort to transfer internal body heat to the outside environment via the skin (perspiration) and respiratory system. This takes place primarily due to major changes in the heart rate, which has the potential to increase by thirty (30) beats per minute for each degree increase in core body temperature. We discourage using the sauna if you have congestive heart failure or uncontrolled high blood pressure.
Alcohol / Alcohol Abuse:
Contrary to popular belief, it is not advisable to attempt to “Sweat Out” a hangover. Alcohol intoxication decreases a person’s judgment; therefore they may not realize it when the body has a negative reaction to high heat. Alcohol also increases the heart rate, which may be further increased by heat stress.
Chronic Conditions / Diseases Associated With A Reduced Ability To Sweat Or Perspire: Parkinson’s, Multiple Sclerosis, Central Nervous System Tumors and Diabetes with Neuropathy can impair sweating.
Insensitivity to Heat:
An individual who has insensitivity to heat should not use the Infrared Sauna.
Pregnant women should not use the Sauna because fetal damage can occur with an elevated body temperature.
An individual that has a fever should not use the Infrared Sauna.
If you have a recent joint injury, it should not be heated for the first 48 hours or until the hot and swollen symptoms subside. If you have a joint or joints that are chronically hot and swollen, these joints may respond poorly to vigorous heating of any kind. Vigorous heating is strictly contra-indicated in cases of enclosed infections such as dental, in joints or in any other tissues.
Pacemaker / Defibrillator:
The magnets used to assemble the units of the sauna can interrupt the pacing and inhibit the output of pacemakers. If you have a pacemaker or defibrillator, you should not use the Infrared Sauna Bed.
Diuretics, barbiturates and beta-blockers may impair the body’s natural heat loss mechanisms. Some over the counter drugs such as antihistamines may also cause the body to be more prone to heat stroke. During your session, slightly open the door of the sauna to allow cool air to come in if you are feeling too hot.
The core body temperature of children rises much faster than adults. This occurs due to a higher metabolic rate per body mass, limited circulatory adaptation to increased cardiac demands and the inability to regulate body temperature by sweating.
The ability to maintain core body temperature decreases with age. This is primarily due to circulatory conditions and decreased sweat gland function. The body must be able to activate its natural cooling processes in order to maintain core body temperature. During your session, slightly open the door of the sauna to allow cool air to come in if you are feeling too hot.
Heating of the low back area of women during the menstruation period may temporarily increase their menstrual flow. Some women endure this process to gain the pain relief whereas others simply choose to avoid sauna use during that time of the month.
Metal pins, rods, artificial joints or other surgical implants generally reflect far infrared waves and thus are not heated by this system. The usage of the Sauna must be discontinued if you experience pain near any such implants. Silicone does absorb infrared energy. Implanted silicone or silicone prostheses for nose or ear replacement may be warmed by the infrared waves. Since silicone melts at over 392°F, it should not be adversely affected by the usage of a Sauna. It is still advised that you check with your surgeon to be certain.
Waiver of Liability and Agreement for INFRARED SAUNA
1. I, the undersigned, consent to the Infrared Sauna Treatment. I understand that these procedures are for the purpose of detoxification and are not intended to take place of the medical care or medications. I clearly confirm that I do not have any contraindications to the Infrared Sauna Treatments. I understand that I can discontinue my treatments at anytime. I understand that I take full responsibility for my own health and wellbeing. I agree to pay my account in full for every treatment.
2. I agree to disclose to Frost and Float Spa LLC if my medical health history should happen to change during the time period of receiving Infrared Sauna Treatments.
3. I have read the above disclaimer (including cautions and contraindications for the use of the Infrared Sauna) and I agree that I am not currently suffering with any of the above-mentioned contraindications. I have read the recommendation sheet, I have been informed about the fees, I have had the opportunity to ask any question about its content, and by signing below I agree to release Frost and Float Spa LLC and it’s staff from any liability in connection with the use of sauna. We do not release your name or information to any third party.