Hydro Ground Zero (HGZ)– Medical Questionnaire  Logo
  • Hydro Ground Zero (HGZ)– Medical Questionnaire

  • Client Information

  •  - -
  • Medical History

    Please answer honestly. Tick Yes/No and providedetails if Yes.
  • Acknowledgement

  • Powered by Jotform SignClear
  • Liability Waiver

  • • I hereby release, indemnify, and hold harmless Wellness Pillars Club, its directors, staff, and contractors from any liability, claims, or damages arising from my participation inHGZ sessions, except where caused by their proven negligence or as otherwise required by law.


    • I understand that participation is voluntary and that I may stop at any time.


    • I acknowledge that results vary between individuals and no guarantee of outcome has been made.

     

  • Consent

  • • I have read and understood this form.

    • I declare that the information provided is true and complete.

    • I consent to participate in Hydro Ground Zero (HGZ) sessions at Wellness Pillars Club.

  • Powered by Jotform SignClear
  • Should be Empty: