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CRYOTHERAPY INTAKE
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Cryotherapy/Sauna/Compression Intake Form & Waiver
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CLICK FREE DRAW TO READ PDF
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Medical History
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Are you currently under medical care?
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If yes - please explain:
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High Blood Pressure
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Any Heart Disorder?
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Unstable Angina?
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Asthma / Shortness of Breath?
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Congestive Heart Failure?
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Any Electronic Implant / Device?
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Kidney / Urinary Tract Disorder?
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Deep Vein Thrombosis?
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Seizure Disorder?
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Any open wounds or sores?
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Any blood disorders?
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Are you under the influence of drugs or alcohol?
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Cold allergies with skin reaction?
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Claustrophobia?
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Are you pregnant?
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Chronic Obstructive Pulmonary Disease (COPD)?
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How did you hear about us?
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