• LOS ANGELES Vaginal Steam Facilitator Intake Form

    Provided by @Thehoneythrone
  • Steam at your own risk.


    Herbal Steam Practitioners and Consultants do not diagnose conditions, nor do they prescribe substances or perform medical treatment, nor interfere with the treatment of a licensed medical professional. It is recommended that you see a licensed physician, or licensed health care professional for any physical or psychological ailment you may have.

    Avoid Yoni Steams if:
    • You are pregnant or think you may be pregnant
    • During or after ovulation (IF YOU ARE TRYING TO CONCEIVE) 
    • You are on your cycle (bleeding)
    • If you have an IUD or another contraceptive device in place you may only steam for 10 minute sessions
    • Avoid Yoni Steams if:
    • You are pregnant or think you may be pregnant
    • During or after ovulation (IF YOU ARE TRYING TO CONCEIVE)
    • You are on your cycle (bleeding)
    • If you have an IUD or another contraceptive device in place you may only steam for 10 minute sessions
    • Have any vaginal and or anal or lower body, wounds, open sores, outbreaks, redness etc?
    • When trying to support infertility or a specific condition where there may be particular contraindications to be aware of.
    • Piercings will need to be removed
    • When trying to support infertility or a specific condition where there may be particular contraindications to be aware of.
    • Piercings will need to be removed

  • MONTHLY STEAM MEMBERSHIPS AVAILABLE

     

  • Contraindications

    There are times when it is not beneficial for a woman to steam. First, let's check and make sure that you don't have any contraindications.
  •  
  • IMPORTANT

    The above "Yes" replies indicate that vaginal steaming is contraindicated. It may not be safe and could result in negative side effects such as the onset of bleeding, an outbreak, a miscarriage or a birth control failure. Steaming should not be performed at this time.

    If a birth control contraindication, it is up to the client whether or not she would like to do the 15 minute steam session with the possible pregnancy risk.

  • Sensitivities

    Some women are very responsive to steam. If you are in this category then it is okay to steam, however your practitioner will adjust your steam session and herbs so that it perfectly suits you.
  •  
  •  
  • The above "yes" replies indicate sensitivity in which case a mild setup with or without a burner. 

  •  
  • Herb Selection

    It is best to select herbs suitable to your constitution. Your practitioner will use the info from this intake form to select a suitable vaginal steam formula for you.
  •  
  •  
  • (for example, citrus peels or cornsilk should not be used if someone has orange or corn allergies).

  • Waiver

  • PLEASE READ -- IT'S NOT THE NORMAL BLAH BLAH BLAH]

    Most of the side-effects reported while steaming are positive. Users have reported better sleep, relaxation, decreased swelling in legs and feet, vaginal tightness and wetness, decreased abdominal bloating, slimmer waistline, increased libido and sexual sensation; increased vaginal nectar and fertility, decrease in breast soreness, fewer headaches, fewer PMS symptoms and improved emotional balance, increased circulation and energy, tingling feet, glowing skin, reduction in incidence of hormonal acne and increased lubrication and vaginal nectar, scar softening, tighter vaginal canal and harmonization with the moon cycle.

    WHAT TO EXPECT
    Steaming is a cleanse. Some of the possible signs the vaginal steaming is working is if you experience -- the urge to urinate while steaming, brown discharge after steaming, increased clots or cramps during the period, increased dry cramps, increased irregular vaginal discharge (clear), emotional release, periods that come earlier or later than expected. All of these signs are a normal part of the cleansing process and these signs will go away once the cleanse is complete. Please note these changes and let your practitioner know of these positive changes.

    BEST PRACTICES
    1) You may have to go to the bathroom directly prior to vaginal steaming.
    2) Learn proper period care. Avoid tampon use and instead use cotton pads or period panties. The period is a uterine cleanse and if you support it the clots can easily clear out. Plugging up with tampons, on the other hand, prevents the old residue from clearing out and that is often be the cause of cramping. It's also important to rest during the period and to eat the right foods.
    3) Increased vaginal discharge can be addressed by using cotton underwear liners and a peri-bottle throughout the day to clean mucus off the skin.


    CAUTION SIGNS
    • Have a vaginal and or anal infection or open wounds, sores, boils etc

    Steam at your own risk we are not responsible for allergic reactions, blisters etc. or any other conditions.

    If steaming causes a rash,itchiness, diarrhea or the onset of fresh spotting or inter-period bleeding, this could be a sign that your steam protocol or herbs might need to be adjusted or that there is an allergic reaction. If these signs occur please let your practitioner know so they can adjust the steam session as necessary or make a referral.
    ****
    In 99% of all cases using a mild steam session and mild herbs will prevent any of the above signs from happening so it's very important that you give honest answers in this intake form so that the practitioner can set up a steam session that will fit your needs.
    ****
    Note: Your vaginal steam specialist’s have a Vaginal Steam Facilitator certificate. This certification ensures that your practitioner knows the proper safety standards regarding setting up a vaginal steam session tailored to fit your needs.

    I understand that vaginal steaming may have positive or negative side effects as a result of doing a vaginal steam session. I accept legal responsibility for my choice to do a vaginal steam session and waive the responsibility of the practitioner and the facility where the steam session takes place in the case that any of the named side effects (or others) may occur.

    My printed name and date below represent my signature.

  • Clear
  • Should be Empty: