Are you currently being treated for the following conditions?
Any other condition that is affected by high temperatures
The above conditions do not necessarily mean the client cannot receive the Hydration Station™ system sessions. However, it is recommended that they should receive a medical release prior to a Hydration Station session. Please not infrared heaters at the top of the bed must stay 6 inches away from all skin. By checking the box, I confirm that the answers to the questionnaire are true and correct. I have read contents of this Personal Profile, Health History and Consent Form carefully and state I am not aware of medical conditions or any other reason that would prohibit me from receiving Hydration Station session understand individual results may vary. I have been given instructions for the proper use of the equipment.
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