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Intake Form

Far Infrared Sauna

BASIC INFORMATION

Contraindications

Are you currently Pregnant?
Yes
No
Not Sure
Are you taking any medications?
Yes
No
Not Sure
Have you been diagnosed with any medical condition, such as anhidrosis, that may limit or prevent your ability to sweat?
Yes
No
Not Sure
Do you have unstable angina?
Yes
No
Not Sure
Do you have any heart conditions?
Yes
No
Not Sure
Do you have severe arterial disease?
Yes
No
Not Sure
Have you had any surgeries in the last 12 weeks?
Yes
No
Not Sure

PRECAUTIONS


• Medications - exposure to infrared waves or elevated body temperature can possibly change the effect of prescription drugs. Some OTC drugs, such as antihistamines, may also cause the body to be more prone to heat stroke. Some may lead to dizziness. Check with your personal physician or pharmacist before using sauna.


• Fever – If you are experiencing a fever, you should not use the sauna at this time.


• Alcohol – It is not advisable to attempt to “sweat out” a hangover. Alcohol intoxication can diminish a person’s judgement and not realize when the body has a negative reaction to high heat. Alcohol also increases the heart rate, which may further increase heat stress.


• Cardiovascular Conditions – Individuals with cardiovascular conditions or problems (hypertension/hypotension), congestive heart failure, impaired coronary circulation or those who are taking medication, 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.


• Pregnancy/Menstruation – Please consult a physician before using the sauna because fetal damage can occur with a certain elevated body temperature.


• Chronic Conditions - Multiple Sclerosis, Central Nervous System Tumors and Diabetes with Neuropathy are conditions that are associated with impaired sweating. Consult a physician before using the sauna.


• Lotions/Chemicals – Do not use chemicals or lotions prior to your session. These items may block pore and affect perspiration.


• Implants/Artificial Joints – Metal pins, rod, artificial joins or any other surgical implants generally reflect far infrared waves and thus are not heated by this system. It is still recommended that you should consult your surgeon prior to using an Infrared Sauna. Certainly, the usage of an Infrared Sauna must be discontinued I you experience pain near any such implants. Silicone does absorb far infrared energy. Implanted silicone or silicone prostheses for nose or ear replacement may be warmed by the far infrared waves. Since silicone melts at over 200 degrees Celsius, it should not be adversely affected by the usage of an Infrared Sauna. It is still advised that you check with your surgeon and possible a representative from the implant manufacturer to be certain.


• Hemophiliacs/Individuals Prone to Bleeding – the use of Infrared should be avoided by anyone who is predisposed to bleeding.


• Recent Joint Injury – If you have a recent (acute) join injury, it should not be heated for the first 48 hours after an injury 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 cased of enclosed infections be the dental, in joints or in any other tissues.


It is always important to maintain proper hydration levels during Far-infrared therapy. Dehydration will actually increase carbohydrate utilization and cause less fat to be burned for energy. It is recommended drinking a minimum of 8 oz. water prior to entering the sauna and minimum of 8 oz. of water after sauna use.


In the event that any dizziness, light-headedness, pain or discomfort is experienced, immediately discontinue sauna use.

WAIVER

 PLEASE BE ADVISED


Far-Infrared Sauna Agreement

1. The use of drugs, medications or alcohol prior to or during the sauna session may lead to dizziness or unconsciousness.


2. Please consult your physician if you are in doubt of your ability to use the Far-infrared for health reasons.


3. No Clients under the age of 18 are permitted in the Far-infrared Sauna unless accompanied by a supervising adult.


4. Please discontinue the use of the sauna if you fee light-headed, dizzy, heat exhausted.


5. Sauna session should be limited to 40 minutes and temperatures must stay below 150 degrees F.


6. It is advisable to drink plenty of after before and after sauna session. Water bottles are not permitted in the sauna.


7. It is advised not to eat at least one to two hours prior to your sauna to avoid any ill feelings.


8. Clients using any medications must consult a physician or pharmacist prior to the use of the sauna.


9. Pregnant women should consult their physician prior to use of the sauna.


10. Do not use any chemicals or lotions prior to your sauna session.

 

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 and any of my heirs, executors, representative or assigns hereby release from all claims or liabilities for personal injury or property damages of any kind sustained while on the premises, during the use of the Far-Infrared Sauna and from any advice provided by an employee, independent contractor or any representative. I agree that this Application and Waiver is in effect for all Far-Infrared Sauna sessions and will not expire unless requested by either party.


Love Your Gut Ministries does not provide medical advice or treatment. 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. 

Please Print and sign your name below to confirm you understand all of the benifits this session will provide.

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