Infrared Sauna Consent Form

Ultraformer MPT Patient Consent Form

CLIENT DETAILS

Address

MEDICAL HISTORY

Medical History

CLIENT GOALS

Client Goals

Sauna Information

Infrared Sauna uses infrared heat to warm the body and may support relaxation, circulation, recovery and general wellbeing.

Results vary between individuals and should not be considered medical treatment.

Contraindications

  • Pregnancy
  • Uncontrolled Heart Condition
  • Uncontrolled Blood Pressure
  • Fever or Active Infection
  • Severe Heat Intolerance
  • Recent Medical Event without clearance
  • Any condition where heat exposure is contraindicated

RISKS & POSSIBLE SIDE EFFECTS

Risks & Possible Side Effects Acknowledged(Required)

EXPECTED RESULTS & LIMITATIONS

Expected Results & Limitations(Required)

PHOTOGRAPHY, VIDEO & MARKETING CONSENT

Photography & Marketing Consent(Required)
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PRIVACY POLICY

Privacy Policy Consent(Required)

Clinical records and photographs may be retained according to Australian law and insurer requirements.

FINANCIAL, REFUND & CANCELLATION POLICY

Completed treatments are non-refundable except where required by Australian Consumer Law. Late cancellations and no-shows may result in fees or loss of deposit.

COMPLAINTS POLICY

Complaints Policy Agreement(Required)

This treatment is wellness-based and not intended to diagnose, treat, cure or prevent disease. No verbal or written statement constitutes a guarantee of outcome. Nothing in this agreement excludes rights under Australian Consumer Law. The practitioner reserves the right to refuse or postpone treatment if unsuitable.

PATIENT DECLARATION

Patient Declaration(Required)

SAUNA SESSION RECORD

Aftercare

  • Drink plenty of water before and after sauna use
  • Rise slowly after treatment
  • Avoid alcohol before and immediately after treatment
  • Stop treatment if feeling unwell
  • Contact the clinic if unusual symptoms occur

FOLLOW-UP REVIEW

SIGNATURES

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