FAR INFRARED SAUNA CLIENT INTAKE AND WAIVER

Emergency Contact Phone*:

Infrared heat is required for all living things to achieve optimum health. Although infrared light is not visible to the naked eye, it generates a radiant heat that has the ability to penetrate deep into the body on a cellular level by raising our core body temperature. This heat increases the thermal energy deep within tissues, muscles and joints to stimulate a range of health benefits.

It is important to understand that Far Infrared (FIR) Sauna Therapy is not advised for everyone and should be carefully considered.
Please complete the checklist below to help identify any considerations that are specific to you prior to your session.

Have you used Far Infrared (FIR) Sauna Therapy before?*
YesNo

Do you suffer from or have you been diagnosed with any type of heart or cardiovascular condition?*
YesNo

Do you suffer from any bleeding disorders or high/ low blood pressure?*
YesNo

Do you have any kind of inflammation or Infection?*
YesNo

Have you recently consumed intoxicants or any kind of drugs?*
YesNo

Are you pregnant?*
YesNo

Are you breastfeeding?*
YesNo

Do you have a history of dizziness, fainting spells, heat sensitivity, narcolepsy or seizures?*
YesNo

Are you aware of any medication you are taking that may be impacted by you using an Infrared sauna?*
YesNo

Individuals who are using prescription drugs should seek the advice of their personal physician or a pharmacist for possible changes in the drug's effect when the body is exposed to infrared waves or elevated temperatures. Some medications including diuretics, barbiturates, and beta-blockers and others 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.

Do you suffer from any type of condition or illness which may be adversely affected by the use of an Infrared sauna?*
YesNo

Do you smoke?*
YesNo

Smokers are not permitted to use the sauna as the wood surface absorbs tobacco odour released from the pores of the body. This will cause damage to the sauna along with potential allergic reactions and discomfort to other clients.

If you answered "Yes' to any of these questions it is not recommended that you use the Far Infrared Sauna at this time. For your safety, we suggest consulting with your General Practitioner to obtain a release form in order to utilise the Far Infrared Sauna.

Consent to use the Far Infrared Sauna is conditional upon provision of accurate answers to the above questions and signing the Far-infrared Sauna Agreement. Self-treatment of any disease with an infrared sauna is not recommended without direct supervision of a certified physician.

Have you consulted your Doctor regarding your ability to use the Far Infrared sauna?*
YesNo

CONTRAINDICATIONS

Infrared sauna use is contraindicated for people with following conditions:

• Pregnancy

• Hemophilia

• Fever

• Insensitivity to Heat

• Alcohol / Alcohol Abuse

PLEASE NOTE

• The use of drugs, medications, or alcohol prior to or during the sauna session is not permitted as this may lead to dizziness or unconsciousness.

• No one under the age of 18 is permitted in the Infrared Sauna unless accompanied by a supervising adult.

• Elderley patients should consult their physician before proceeding with an Infrared Sauna session.

• Exit immediately if you feel light-headed, dizzy or heat exhausted.

• Staying too long in a heated area may cause overheating

• Supervise children at all times

• Check with a doctor before use if pregnant, in poor health, or under medical care

• Breathing heated air in conjunction with consumption of alcohol, drugs, or medication may cause unconsciousness

• Excessive exposure to heat can have harmful effects on health

RECOMMENDATIONS

• We suggest that you drink atleast 1.5L of water prior and stay hydrated throughout your sauna session. Use a good quality electrolyte, vitamin/mineral supplement or green drink to replace the minerals lost in your perspiration post treatment.

• If you wear contact lenses, please remove them during your sauna session.

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

CONSENT FOR FAR INFRARED SAUNA TREATMENT

I acknowledge and accept the risks inherent in the use of the Far Infrared Sauna. I voluntarily assume the risk of injury, accident or death, which may arise from the use of the Far Infrared Sauna.

I consent to release La Peau Skin Rejuvenation and its subsidiaries from any claims that I have or may have in future relating to personal injury or property damages of any kind sustained while on the premises, during the use of the Far Infrared Sauna. I understand that La Peau Skin Rejuvenation and its representatives do not provide medical advice and are responsible for any misinformation provided by myself.

I understand and agree that this waiver is in effect for all Far Infrared Sauna sessions and will not expire unless requested by either party.

Far Infrared Sauna use may or may not be appropriate for you. Please consult your health care provider for medical advice. The information provided is for general information purposes only and does not address individual circumstances or medical conditions. Do not attempt to self-treat any disease with a Far Infrared Sauna.

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