Southtowns Colon Hydrotherapy: Go To Wellness Center T-Shape 2 Waiver & Assumption of Risk

By engaging Southtowns Colon Hydrotherapy: Go To Wellness Center (the "Company") to provide T-Shape 2 sessions and related services (the "Services"), I acknowledge that there are certain inherent risks and dangers associated with these Services. I agree to comply with all posted safety signs, rules, and verbal instructions from staff.

I assume full responsibility for any and all injuries or damages sustained by me in relation to the Services. I release, indemnify, and hold harmless the Company and all related entities from any and all liability, claims, costs, and damages arising from the Services.

I represent that I have no medical or physical condition preventing me from receiving the

Services and understand that these Services do not constitute medical or healthcare

treatment. Staff at the Company are not medical professionals and cannot diagnose or treat

I understand that I may be photographed or recorded for safety or training purposes and

I have read and fully understand this waiver, and I voluntarily agree to its terms.

Risks, Limitations, and Contraindications for T-Shape 2

Pregnancy or lactating

Active implanted devices (pacemaker, urethral stimulator, internal defibrillator)

Varicose veins in the treatment area

Thrombophlebitis

Active cancer or cancer treatments in the past five years (without doctor's clearance)

Current outbreak of hives or active herpes Glandular swelling, vitiligo, lupus

Accutane or recent use of skin medications

Recent surgery or fillers in treatment area

Botox in past two weeks (treatment area)

Open lesions in treatment area

Implant contraceptive (Nexplanon) if treating arms

PDO threads within last 4 months

Consult Medical Director/Physician if:

Hypotension or hypertension

Dilated capillaries

Liver or kidney disorders

Poorly controlled diabetes (Type 1 or 2)

Keloid scarring

Oral or topical acne medications

Anticoagulant therapy

Hormone pellets (avoid insertion site)

Sensitivity to light or photosensitive medications

Metal or mesh implants in desired area (remove piercings before treatment)

Undiagnosed lumps or other health concerns - consult physician prior to treatment.

I have read and acknowledged the above risks, limitations, and contraindications of T-Shape