Cryotherapy Consent – Fusion Wellness
Cryotherapy Consent & Waiver
Fusion Wellness  ·  Fort Lauderdale, FL

◉   Contraindications — Cryotherapy is not suitable for individuals with:
Untreated Hypertension
Heart Attack Within The Past 6 Months
Decompensating Diseases of the Cardiovascular & Respiratory System
Congestive Heart Failure
Chronic Obstructive Pulmonary Disease (COPD)
Chronic Liver Disease
Unstable Angina Pectoris
Pacemaker
Peripheral Artery Occlusive Disease
Deep Vein Thrombosis (DVT) or Known Circulatory Dysfunction
Acute Febrile Respiratory Disease
Acute Kidney and Urinary Tract Diseases
Severe Anemia
Cold Allergenic Phenomena (Allergy to Cold Contactants)
Seizure Disorders
Bacterial or Viral Skin Infections / Open or Discharging Wounds
Alcohol or Drug Use
Valvular Heart Disease
Ischemic Heart Disease
Raynaud's Disease
Polyneuropathy
Pregnancy
Vasculitis
Claustrophobia
Hyperhidrosis (Heavy Perspiration)
I confirm that I do not have any of the contraindicated conditions listed above and agree to notify Fusion Wellness staff of any changes to my health status before future sessions.

⚠ Important: Notify staff immediately if you experience dizziness, numbness, shortness of breath, or any unusual discomfort during your session. You may stop your session at any time.


Please sign below using your finger (mobile/tablet) or mouse (desktop):

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Your information is kept strictly confidential and used solely for treatment purposes.