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Halotherapy Waiver

ACKNOWLEDGMENT OF RISKS

I understand that the use of halotherapy involves certain inherent risks, including but not limited to respiratory discomfort, dry throat, skin irritation, or other physical discomforts. I acknowledge that I have been advised to consult with a healthcare professional before using halotherapy, particularly if I have any medical conditions such as asthma, chronic obstructive pulmonary disease (COPD), allergies, pregnancy, or if l am taking medications that could be affected by exposure to fine salt particles.

HEALTH DISCLOSURE

I confirm that I do not have any medical conditions, illnesses, or injuries that would make the use of halotherapy unsafe. I further confirm that I am not under the influence of alcohol, drugs, or any other substances that could impair my ability to safely participate in halotherapy sessions.

ASSUMPTION OF RISK AND VOLUNTARY PARTICIPATION

I voluntarily choose to participate in halotherapy and expressly assume all risks associated with its use, including but not limited to respiratory discomfort, dry throat, skin irritation, or any other physical discomforts or injuries that may arise. I acknowledge that while the facility has implemented reasonable safety measures to mitigate risks, it cannot guarantee the prevention of all unforeseen incidents or reactions. By participating in halotherapy, I accept full responsibility for my decision and agree to take necessary precautions, including adhering to time limits and following all instructions and guidelines provided

LIABILITY WAIVER AND RELEASE

In consideration of being allowed to participate in halotherapy, I, on behalf of myself, my heirs, executors, and assigns, hereby release and discharge The Wellhaus its owners, employees, agents, and affiliates from any and all claims, demands, or causes of action arising out of or related to my participation in halotherapy, except in cases of gross negligence or intentional misconduct.

ACKNOWLEDGMENT OF POLICIES
I agree to strictly adhere to all rules, policies, and guidelines provided by The Wellhaus, including but not limited to time limits, hygiene requirements, and any instructions or directives issued by staff members. I acknowledge that these policies are designed to ensure the safety, comfort, and well-being of all participants. I further understand and accept that any failure, whether intentional or unintentional, to comply with these policies may result in the immediate suspension or permanent termination of my access to halotherapy and other related services, without any refund or recourse.
EMERGENCY PROCEDURES
In the event of discomfort or distress during a halotherapy session, participants are advised to immediately cease their session and notify a staff member for assistance. The facility staff will provide necessary support, including removing the participant from the halotherapy room and offering basic first aid or calling for emergency medical services if required. Participants should familiarize themselves with the emergency exits, and any medical conditions should be disclosed to staff before starting the session. The Wellhaus staff will ensure all participants are informed of these procedures prior to their session for safety assurance.
HALOTHERAPY ADA EXEMPTION
Halotherapy rooms are typically small, enclosed spaces with unique design and operational features, such as fine salt particle dispersion, that may not accommodate certain modifications without compromising the intended functionality or safety of the facility.
The nature of halotherapy use involves inherent risks, such as exposure to fine salt particles, which may pose additional hazards for individuals with certain medical conditions or disabilities. As such, you agree that some features may create complications if you have a disability.
The Wellhaus strives to make reasonable efforts to accommodate individuals with disabilities in other areas of our facility and services where possible. We encourage all guests to contact us with questions or concerns so we can explore availably options to enhance their experience while maintaining safety and compliance with applicable regulations.

Full Name

*Full name is required. If the entire name is not typed, we will need the customer to fill out the form again correctly.*

Email

Phone Number

Do you currently have a fever, any uncovered open wounds, have active tuberculosis, or have any contagious diseases?

Do you currently have a fever, any uncovered open wounds, have active tuberculosis, or have any contagious diseases?
A
B

Have you been diagnosed with severe hypertension (high blood pressure)?

Have you been diagnosed with severe hypertension (high blood pressure)?
A
B
C

Are you currently being treated for cancer?

Are you currently being treated for cancer?
A
B

By signing below, I acknowledge that all the information within this form is true and I have read the complete waiver.

Signature

By signing below, I acknowledge that all the information within this form is true on behalf of a minor/ minors.

Signature