Waivers

Waivers can be found inside the confirmation email that is sent when you schedule an appointment or if you sign into your account! If you forget to submit it before your appointment we have tablets at the front desk where you can fill out the needed waivers for your services. Text Versions of the waivers are below if you would like to see them ahead of time.

Floating

We at Total Rejuvenation provide floatation therapy which stimulates blood flow throughout the body’s tissues, provides a deep state of relaxation which allows our brains to enter into the theta brain wave and releases natural endorphins. To ensure a comfortable, clean, and safe floatation experience, I, the undersigned, do hereby agree to and consent to the following:By checking each line, you agree to the following:

__ I do not have any communicable or infectious disease, illness, open sore, or skin disorder (required)

__ I do not have a condition, nor am I medicated in any manner, which may be adversely affected by profound relaxation and/or immersion in concentrated magnesium sulfate (Epsom salt) water solution (required)

__ I am not under the influence of any non-prescription medication, drug or alcohol (required) I do not have a history of high (>180/120) or low (<90/50) blood pressure (required)

__ I do not have kidney disease or chronic heart disease (required)

__ I do not suffer from uncontrolled seizures or epilepsy (required)

__ I will not use the float tank with oils or creams in my hair or on my body (required)

__ I have not applied hair dye, hair product with pigment in it or skin tanning products in the past 10 days (required)

__ I will shower before and after my float, as instructed by a staff member (required)

__ I am not currently menstruating, and if I am, I agree to use an insertable type feminine hygiene product (tampon, cup, etc) (required)

__ If I am pregnant, I have consulted with my healthcare provider prior to using the float tank(required)

__ I understand that if I contaminate the float tank, I may be charged for the replacement of the water, salt and filter up to $1,200 (required)The following are used in the Floatation Pods and Suites: Pharmaceutical grade Epsom salt (Magnesium Sulfate mgSO4)Natural Enzymes and non-toxic, biodegradable cleaning products35% food grade hydrogen peroxide as a disinfectantUltraviolet and Ozone sanitation system

__ I understand the above items are used in the Floatation Pods and Suites (required)

__ I agree to take full responsibility for my thoughts and actions while in the Float Suite and understand that each individual may have a unique experience. I have or will receive(d) an orientation which familiarizes me with the safe and appropriate use of the Float Suite. I hereby confirm that I fully understand all statements above completely and take on all risks associated with Floatation Therapy. (required)

Halotherapy

To help monitor your results please indicate which condition(s) apply to you (or your child):

__ Allergies

__ Asthma

__ Bronchitis

__ Cold and FluCystic fibrosis

__ COPD

__ General wellness (desire to improve)

__ Dermatitis

__ Ear infection

__ (wish to) Increase Endurance

__ Eczema

__ Emphysema

__ Hay fever

__ Enhanced athletic performance

__ Rhinitis

__ Psoriasis

__ Sinusitis

__ Sleep apnea/snoring

__ Smokers cough

__ Stress

__ Detox

__ Other :

__ I have been advised of the following possible side effects: Dry or itchy throat, nasal drip, and increased coughing at the beginning. This is a natural part of the cleaning process of the respiratory system, during which the pollution, accumulated through a long time, and now loosened up by the salt, are expelled from even the deepest regions of the lungs. Such side effects should cease with the removal of pollution and pathogens. Skin irritation and dermal sensitivity may occur. In such a case, decrease the frequency of sessions. (required)

__ The use of Halotherapy is not intended to treat, cure, or prevent any illness or condition. All medical conditions should be treated by a physician competent in treating that particular condition. Do not stop your medication without first consulting with your doctor. The use of Halotherapy does NOT substitute for any conventional medication. The information contained herein is not intended to cover all possible uses, directions, precautions, warning, drug interactions, allergic reactions, or adverse effects. If you have any questions about Halotherapy check with your doctor before proceeding. Halotherapy is not recommended in the following cases: Tuberculosis, fever, contagious conditions, severe heart disorders, existence of cancer, advanced pregnancy, and acute state of respiratory attack. (required)

Sauna

We at Total Rejuvenation want to ensure a comfortable and safe infrared sauna experience.

No session will last longer than 45 minutes.No clients under the age of 16 are permitted in the Sunlighten and Clearlight sauna unless accompanied by a supervising adult. All clients under the age of 18 must have a Guardian’s Signature.

Please read and consent to the following safety requirements:

__ I am not under the influence of drugs or alcohol. (required)

__ I am not pregnant (required)

__ If I feel light-headed, dizzy or heat exhausted I will discontinue the use of the sauna.(required)

__ I have been advised to drink plenty of water before and after my sauna session. (required)

__ I do not take any medications or I have consulted with my physician about my use of an infrared sauna. (required)

__ I have no medical history of circulatory system problems or I have consulted with my physician about my use of an infrared sauna. (required)

Cold Plunge

We at Total Rejuvenation want to ensure a comfortable and safe Cold Plunge experience. No session will last longer than 10 minutes. All clients under the age of 18 must have a Guardian’s Signature.

Please read and consent to the following safety requirements:

__ I have never had a Heart Attack or Cerebrovascular Accident. (required)

__ I do not have Unstable Angina Pectoris. (required)

__ I do not have Arrhythmias. (required)

__ I do not have any Peripheral Arterial Occlusive Disease. (required)

__ I do not have High Blood Pressure (BP>180/100 mmHg). (required)

__ I do not have a Pacemaker. (required)

__ I have not had a Heart Bypass or Valvular Disease. (required)

__ I do not have Congestive Heart Failure. (required)

__ I do not have Chronic Obstructive Pulmonary Diease (COPD). (required)

__ I do not have any major circulatory dysfunction. (required)

__ I do not have cold allergies or have hypersensitivity to cold. (required)

__ I do not have Raynaud’s Syndrome. (required)

__ I do not have any blood disorders (ie. Anemia or Sickle Cell Disease). (required)

__ I do not have Intrathecal Pump Implant (pain pump). (required)

__ I do not have Deep Vein Thrombosis (DVT). (required)

__ I do not have any open wounds, sores. or healing disorders. (required)

__ I am not Pregnant. (required)

__ I do not have a history of Seizure Disorders. (required)

__ I am not under the influence of drugs or alcohol. (required)

__ I am not currently being treated for any infection. (required)

__ I have read the following safety Instructions for Cold Water Plunge Therapy. (required)

NormaTec

We at Total Rejuvenation want to ensure a comfortable and safe NormaTec experience. No session will last longer than 30 minutes. All clients under the age of 18 must have a Guardian’s Signature.

Please read and consent to the following safety requirements:

__ I understand that the use of Normatec is not intended to treat, cure or prevent any illness or condition. All medical conditions should be treated by a physician competent in treating that particular condition. Do not stop your medication without first consulting with your doctor. The use of Normatec does NOT substitute for any conventional medication. (required)