Foot Detox In Take

Foot Detox In Take
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Although ionic foot detox treatments are safe for most people there may be contradictions in which you should not undergo treatment. If you answer yes to any of the following you can not move forward with a foot detox treatment. If you have questions or concerns please consult your physician.
Do you have a pacemaker or any other battery operated or electrical implant in your body? *

Yes No
Currently on a blood thinner medication? *

Yes No
Are you an organ transplant recipient? *

Yes No
Are you pregnant or think you may be pregnant! *

Yes No
Are you currently lactating? *

Yes No
History of epilepsy or seizures? *

Yes No
Currently undergoing any form of radiation or chemotherapy? *

Yes No
Do you have any current open wounds on your feet or suffer from hemophilia? *

Yes No
Currently taking blood pressure medication? *

Yes No
Do you have diabetes? *

Yes No
Ionic foot detox treatments are not intended to diagnose, treat, cure or prevent disease. Steam Sistahs makes no medical claims and makes no statements of validation. I acknowledge that all information is accurate. I First Name* Last Name* understand I am having this foot detox at my own risk and hereby release STEAM SISTAHS from any libability.
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