Infrared Sauna Consultation and Consent Form

Client Details

Full Name: *

Date of Birth: *

Email: *

Contact Number: *

Medical History

Are you taking any medication? *

Please list: *

Do you have any allergies or intolerances? *

Please list: *

Are you currently, or possibly may be, pregnant? *

Do any of the following apply to you? Please tick all that apply.

Do you have any other medical conditions? *

Please list: *

Have you recently been unwell? *

Which of the following were you unwell with? *

Please provide more details: *

Consultation

Have you ever used an infrared sauna before? *

What are your goals and expectations of the treatment? *

Emergency Contact Details

Emergency Contact Name: *

Emergency Contact Relationship: *

Emergency Contact Phone: *

Treatment Information

What is an Infrared Sauna?

Where traditional saunas use heating elements to raise the temperature of the air inside, infrared saunas use infrared light to heat your body while the air around you stays unchanged. The result is your core temperature rising without having to sit in a room where the ambient temperature is close to 200 degrees Fahrenheit. Some people find this more comfortable than traditional saunas.

Treatment Guidance

If you have suffered a recent joint injury that is considered acute, it should not be heated for at least 48 hours or until swelling diminishes.
The use of illegal drugs or alcohol prior to or during the sauna may lead to dizziness or unconsciousness and is strictly prohibited.
It is advised not to have a full stomach to avoid any ill feelings. A good rule of thumb is to not eat for about an hour
prior to your sauna session.
Detoxification can be sudden for some people. These effects may include dizziness, nausea and fatigue. If you
experience these please get out of the sauna to cool and hydrate. Most people do not experience these symptoms.
Extra hydration is important before, during, and after taking a sauna. Along with pure, fresh water, an electrolyte drink, mineral supplement or fresh green juice is recommended.
Glass and open containers are not allowed in the sauna.
Individuals receiving waxing services should not use the sauna before or after a service as it may cause skin sensitivity and irritation; specifically after a waxing service when dead skin cells have been removed with the hair.
Individuals should not use the sauna when they have a fever.
An individual that has insensitivity to heat should not use a sauna.

Infrared Sauna Use Agreement

Discontinue the use of the sauna if you experience any pain and/or discomfort, or feel light-headed, dizzy or heat exhausted
Clients are required to shower both before and after their sauna session
Clients are required to sit on a clean towel during their sauna session

Relax, breathe deep, and enjoy the radiant warmth of your infrared experience!

Consent

Please read each statement carefully and tick to show your agreement. *

I accept that any treatment I am going to receive is at my own risk. I certify that I have read and fully understood and completed this form to the best of my knowledge. I understand that failure to disclose information requested above may result in adverse side effect(s) and therefore I accept full liability/responsibility for the information given. The treatment(s) and possible side effect(s) have been fully explained to me. I accept full responsibility for the treatment given and complications which may arise or result during or following any procedure that is performed at my request. I accept that if I am not satisfied with the treatment I will inform the therapist and/or request to speak to the manager during or immediately following the treatment. I fully understand the above and consent to receive Infrared Sauna therapy.

Client Signature: *

Tap or click on the signature above to sign