contact information
contraindications acknowledgement
Waiver
cryotherapy Treatment rules
CRYOTHERAPY CONSENT FORM
client information

Welcome to Coeur Cryo!

Coeur Cryo Waiver & Release Agreement
Please be sure to read this document in it's entirety before signing.
This is a release of liability and a waiver of certain legal rights. A whole body cryotherapy session involves exposure to extreme cold temperature for a short period of time (not to exceed three (3) minutes per session). Below is a list of absolute Contraindications’ which will preclude you from whole-body cryotherapy. In addition, PLEASE BE AWARE, that if you experience any pain or mental or physical discomfort at any time during the process, you are advised to terminate the session immediately upon your own volition. You will be observed by a technician the entire time while in the chamber, but are free to walk out of the chamber at any time.
Absolute Contraindications
Absolute contraindication means that event or substance could cause a life-threatening situation. A procedure or medicine that falls under this category must be avoided.
  • Untreated Hypertension
  • Heart Attack within the previous 6 months
  • Decompensating diseases (edema) of the cardiovascular and respiratory system
  • Congestive Heart Failure
  • COPD
  • Chronic Liver Disease
  • Unstable Angina Pectoris
  • Pacemaker
  • Peripheral Arterial Occlusive Disease
  • Deep Vein Thrombosis (DVT) or known circulatory dysfunction (blood clots)
  • Acute Febrile Respiratory (Flu-like respiratory conditions)
  • Acute kidney and urinary tract diseases
  • Severe Anemia
  • Cold Allergenic Phenomenon (known allergy to cold contactants)
  • Any form of abnormal heavy bleeding
  • Seizure disorders
  • Bacterial and viral infections of the skin, wound healing disorders (open sores or discharging wound/skin conditions)
  • Alcohol and drugs relative contraindication
  • Valvular Heart Disease
  • Condition after heart surgery
  • Ischemic Heart Disease
  • Raynaud’s Disease
  • Polyneuropathies
  • Pregnancy
  • Vasculitis
  • Claustrophobia
  • Hyperhidrosis – heavy perspiration
  • Diabetes

Rejuvinate Your Body & Mind

We would love to meet you, get to know you, and provide some solutions for your overall health and well-being. When should we start?
LET'S GET STARTED!
envelopephone linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram