Sunlighten Sauna Consent Form
Please review all statements and provide your consent and signatures as required for Sunlighten Infrared Sauna use.
Patient Name
*
First Name
Last Name
Date (Initial Consent - Part 1)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I have read and understand the contraindications for use of the infrared sauna and acknowledge that none apply to me.
*
I agree
I understand that my signature on this consent form will be applicable for all future Infrared Sauna treatments.
*
I understand and agree
I will update Pua Manu Medspa with any changes in my medications or medical history.
*
I agree to update my information
Patient Signature (Part 1)
*
Date Signed (Part 1)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Witness Signature (Part 1)
I have carefully read the above safety instructions for using a Sunlighten sauna. I fully understand them and fully agree to comply with instructions.
*
I have read, understand, and agree to comply
I acknowledge and accept these risks and release Pua Manu Medspa as described above.
*
I acknowledge and accept these risks and release Pua Manu Medspa as described above
This agreement is in effect for all Sunlighten sauna sessions/treatments and will not expire unless requested by either party.
*
I understand and agree
Patient Signature (Part 2)
*
Date Signed (Part 2)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Witness Signature (Part 2)
Submit Consent
Submit Consent
Should be Empty: