Consultation Form Contrast Therapy

I assume full responsibility for my medical/health conditions. I know my own limitations and assume all risks associated with any activities in which I may engage in at the Contrast Therapy Suite.
Cardiovascular Conditions, Medications, Chronic Conditions/Diseases Associated With Reduced Ability to Sweat or Perspire, Hemophiliacs/Individuals Prone to Bleeding, Fever, Insensitivity to Heat, Joint Injury, Implants: metal pins, rods, artificial joints, Pacemakers/Defibrillators, Pregnancy/Breastfeeding; If any of these conditions apply to me, I agree to consult a physician prior to participating in hot and cold therapy.
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.
I accept that I am participating in hot and cold therapy and I deem myself physically and emotionally capable of participating in these activities. I consent to release and indemnify staff and any and all liability in connection with the use of the sauna(s) and cold plunge, whether such loss or damage be direct or indirect.
I understand that eyeglasses should not be used in the hot room as they can become damaged in the heat. I understand that contact lens wearers may experience discomfort and should be prepared to remove contacts if this is the case.
I certify that I have read and fully understood and completed this form to the best of my knowledge.
I fully understand the above and consent to receive a wellness session.