Start healing with Hyperbaric Oxygen
Consent Agreement to Treatment
Please read and acknowledge each of the following statements by signing below.
- I understand that hyperbaric oxygen therapy is not intended to diagnose, treat, cure, or prevent disease. In addition, I recognize that while hyperbaric oxygen therapy may enhance healing, it does not replace a health professional’s prescribed medications or recommended treatments.
- I understand that hyperbaric oxygen therapy uses an increase in atmospheric pressure in a sealed chamber to allow the body to absorb more oxygen (approximately 91%) at a cellular level to promote healing and wellness. I understand that the amount of atmospheric pressure used by HBOT Services, LLC is 1.3 absolute atmospheres, or 4.4 psi.
- I understand that hyperbaric oxygen therapy is reported to be beneficial for a wide range of medical ailments, but no therapeutic outcomes can be guaranteed. I recognize that while the FDA recognizes specific conditions that directly benefit from mild hyperbaric oxygen therapy, there are many additional “off- label” conditions, which have been studied with positive results. As with any therapy, there are no guarantees as to any positive physical or emotional response, and the fees are for services rendered and not benefits received. I procure this therapy at my own risk. I understand that I may neither observe nor realize any benefit from the hyperbaric treatment. I understand that hyperbaric oxygen therapy is not a substitute for any medical treatment prescribed or suggested by my physician.
- I understand that as the chamber is pressurized and depressurized I may need to equalize the pressure in my ears to acclimate to the pressure changes and may experience “popping” in my ears. This is normal. If I am unable to equalize the pressure in my ears, the therapy session may be terminated.
- I understand that I may experience minor ear, sinus, or other discomfort. I acknowledge that a HBOT Services, LLC attendant is present to work with me to provide comfort in the event of any discomfort I may experience, but that the attendant is not a trained health care worker. I understand that this is not a medical facility.
- I attest that I am a consenting adult over the age of 18 and that I agree to enter (and/or permit my child to enter) the mild hyperbaric chamber of my own free will. I am entering the chamber at my own risk and without the coercion or sales pressure from any associate of HBOT Services, LLC.
- I am not aware of any physical conditions of which I suffer or have that would or should preclude my undertaking this therapy. If I have any doubts, concerns, or questions, I will, prior to undertaking such therapy, see and obtain medical advice from a licensed physician. In addition, I understand that it is my sole responsibility to update HBOT Services, LLC regarding any changes to my medical status or medications each time I receive treatment.
Acknowledgement of Policies
- I agree not to bring food or drink into the chamber. I understand that the exception to this rule is if I have diabetes, in which case I will bring an appropriate snack to each session in case my blood sugar drops during treatment. I also agree not to bring flammables into the chamber.
- I understand that it is important to have eaten food at least one hour prior to hyperbaric oxygen treatment.
- I understand that I should not be dehydrated at time of the hyperbaric oxygen treatment.
- I understand that smoking and nicotine interfere with the benefits of hyperbaric oxygen therapy. Therefore, I agree to abstain from smoking or using a nicotine patch 2 hours prior to my appointment time.
- I understand if I am taking medications it is best to consult with my doctor before taking any hyperbaric oxygen treatments.
- I understand that I should not fly or drive to a higher altitude within 12 hours after completing a hyperbaric oxygen treatment.
- I understand that if I have had any recent dental work: especially fillings, I must wait 48 hours before going starting any hyperbaric oxygen treatment.
- I understand that I must arrive 15 minutes prior to my scheduled appointment.
- I understand that after my session, it will take an additional 15 minutes for the chamber to depressurize.
- I acknowledge that my treatment scheduled time could be adjusted to accommodate for any time loss for late arrival.