Attention:
● HBOT will be denied if you have or suspect to have the following: Pneumothorax, Pulmonary Embolism, Hereditary Spherocytosis, or Sickle Cell Anemia. If you are unable to clear your ears.
● HBOT will be denied if you are taking the following medications: Bleomycin, Disulfiram, & Mafenide Acetate.
● HBOT is NOT recommended during pregnancy. You will be denied HBOT if you are pregnant. ● Always seek the advice of a physician or other qualified health provider with any questions you may haveregarding a medical condition. Never disregard professional medical advice or delay seeking medical treatment

Emergency Contact

We take great pride in the time and service that we provide to our clients. We take your time seriously and are committed to serving you with the highest level of respect, integrity and in the most cost-effective manner. We understand that some client cancellations are inevitable. Cancellations without 24-hr notice, missed appointments, no shows, and being late for a scheduled appointment are a great expense to our organization.
We will institute the following cancellation policy: There will be a $50 charge for each cancellation/no show without a 24-hour notice.
Late shows may need to be shortened or rescheduled to keep our following appointments on time. If you are more than 15 minutes late without a call, we will consider this the same as a no show.
If for any reason you are unable to complete any unused sessions of a purchased package, there will be no refund. We can work with you by keeping the package available for whenever you are ready to come back. We will also allow for any unused portion to be transferred to another person. We will not issue a refund.
As an active client of Oxygen Health Spa, I will adhere to these policies and be financially responsible for any fees incurred because of missed or excessively late appointments. I understand that I will not receive a cash refund in the event you choose not to complete your therapy package.

CONTINUE ONLY IF:
*You do NOT have or suspect having: Pneumothorax, Hereditary Spherocytosis, Sickle Cell Anemia or Pulmonary Embolism
* You are not pregnant or taking any of the previously mentions medications

I hereby request and give consent to Oxygen Health Spa, to the staff, to provide Hyperbaric Oxygen Therapy
The technology known as Hyperbaric Oxygen Therapy (HBOT) has been reported to have beneficial effects for a wide range of conditions, without negative side effects. While beneficial there are no claims that this treatment will heal or cure any illness or disease.
As with many treatments there are areas of concern which you should be aware. It is important that you take a few minutes to read the following information.
Pneumothorax can become Tension Pneumothorax if treated with HBOT. There should be absolutely NO CHEST PAIN during your session. Notify us immediately if you are experiencing chest pain. Your session will end and we will recommend getting a chest Xray before returning to HBOT.
OTIC BAROTRAUMA is a condition of injury to the eardrum and is unlikely to occur in the Hyperbaric Chamber. However, severe ear discomfort can be caused if you cannot equalize the pressure in your ears as the pressure changes and pain can lead to Otic Barotrauma. It is your responsibility to clear your ears in whichever manner works best for you. IT IS CRITICAL THAT YOU COMMUNICATE ANY DISCOMFORT IMMEDIATELY TO THE STAFF. This will give us the opportunity to adjust the pressurization or depressurization process to eliminate discomfort before you experience pain. If you are unable to equalize the pressure in your ears the session will be immediately terminated. If this happens or if pain persists beyond the visit, we recommend that you consult your physician to evaluate and alleviate the situation before attempting another visit.
EAR, SINUS, THROAT CONGESTION, HEAD COLDS, VIRUS OR PRIOR TRAUMA TO THE EARS You may consider rescheduling your visit in the chamber if you are suffering from any of these conditions. PULMONARY HYPEREXPANSION This condition is very rare under Hyperbaric treatments. However, to be overly cautious, HOLDING YOUR BREATH DURING DECOMPRESSION MUST BE AVOIDED! In the highly unlikely event of an unexpected rapid decompression, it is critical that you exhale immediately.

HOW TO PREPARE FOR YOUR UPCOMING HYPERBARIC CHAMBER APPOINTMENT

● No makeup, perfumes, lotions, skin oils of any kind. This helps to keep scents out of the chamber that are hard to remove and may irritate other clients.
● Please wear comfortable loose-fitting cotton or cotton type clothing. Please wear socks. ● All jewelry: earrings, necklaces, bracelets, and watches must be removed.
● Absolutely no lighters, matches, or chemical personal warmers in the chamber.
● Pockets emptied of loose coins, knives, ammunition, lighters, or any other items. Wallets and purses must remain out of the chamber in the area designated to you or they may be held at the reception desk.
● Hearing aids and other medical devices that can be removed, need to be removed and placed in basket provided.
● For your safety no battery-operated object is allowed into the chamber. This includes cell phones and tablets. You can take a book or magazine.
● Some of you may want to take this time to relax; one hour in the hyperbaric chamber is the equivalent to 4 hours of sleep!

SPECIAL NOTE:

● Congestion may make you unable to clear your ears. If you cannot clear your ears we will need to reschedule.
● If you have had any recent dental work; especially fillings, you must wait 48 hours before going into the chamber.
● This is a safety precaution to preserve the integrity of your fillings.
● Do not fly or drive to a higher altitude within 12 hours after completing a hyperbaric treatment.
● Do not smoke at least two hours before or after receiving a treatment.
● If you are taking medications, it is best to consult with your doctor before taking any hyperbaric treatments.
I have read and understand and agree to the requirements of both pre and post hyperbaric treatment conduct as a client.