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Consent Form

To register to our Spa please fill out the following consent form

Are you pregnant or breast feeding
Heart problems or diseases
High blood presure
Active implanted devices such as a pacemaker or defibrillator
Kidney damage / diseases
Liver damage / diseases
Acute inflammatory processes
Medical plastic parts or parts with metal inside
Abnormal immune system
Numb or insenitve to heat
Skin conditions such as eczema, dermatitis or rashes
Do you have diabeties?
Do you have an abdominal mesh?
Are you taking antibiotics?
Do you have any allergies?

Thanks for submitting!

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