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I understand the services provided by reVIVE Old Town dba VIVE Float Studio + are drugless, non-invasive approaches to address physical, mental and emotional aspects. They can be used as complimentary treatments to prescribed medications or as sole treatments. When used as complementary treatments, they can increase the effectiveness of prescribed medications and decrease the amount subscribed.

I Agree

Although published studies do indicate that these services have health benefits as an addition to more traditional forms of medicine, VIVE Float Studio + does not claim to be a replacement for medication or any medical treatment of any kind. Nothing in this studio is intended to diagnose, treat, or cure any medical condition of any nature, and shall not be construed as medical advice, implied or otherwise.

I Agree

I confirm that no warranty or guarantee, or other assurance, has been made to me covering the results of any of the services, products or equipment offered for use by VIVE Float Studio + Only your personal physician or another health professional can best advise you on matters of your health.

I Agree

I hereby relieve them and hold them harmless from all liabilities for injury or damage that may occur to me. I fully understand the administration of the process, including possible adverse reactions, side effects, or other possible complications.  

I Agree

These services should be avoided during the acute phase of any illness, including the following: infections accompanied by fever, acute active tuberculosis, cardiac insufficiency, COPD in third stage, bleeding, spitting of blood, contagious ailments, have use of an oxygen tank to aid breathing, alcohol or drug intoxication, unstable or uncontrolled hypertension, and acute stages of respiratory diseases.

I Agree

In the event of an emergency, I authorize VIVE Float Studio + to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care and I agree that I will be responsible for payment of any and all medical services required.

I Agree

I declare that I am not under the influence of any substance, legal or otherwise, that would impair my judgment while using the services at VIVE Float Studio +.

I Agree

I will abide by the 24-hour cancellation policy when rescheduling or canceling appointments. Otherwise, I understand that I will be charged the full session price, realizing that this appointment time was exclusively reserved for me.

I Agree

I understand that I am in control of this experience, I take full responsibility for myself, and my body while at VIVE Float Studio + as I use the grounds, facility and all rooms/ amenities.

I Agree

I, as a client of VIVE Float Studio + hereby release VIVE Float Studio + and its directors, officers, employees, agents and professional staff from all actions, causes of actions, suits, claims, liability, damages and demands of any kind, whether direct, indirect, special, exemplary or consequential, including interest therein of VIVE Float Studio + which may occur as a result of any injury including death sustained by myself or others resulting from the receipt of services.

I Agree

I fully understand the above disclaimer and acknowledge that I am voluntarily participating in this service and use the provided services at my own risk. It is understood that this CONSENT is being given in advance of any administration of the process

I Agree

I agree to take full responsibility for myself as I use the grounds, facility and all rooms/ amenities in VIVE Float Studio +.

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I will not misrepresent myself to any agents/staff of VIVE Float Studio + about my ability to operate all equipment in my possession while at VIVE Float Studio +.

I Agree

Pregnant women should consult the physician prior to use of and services at VIVE Float Studio +.

I Agree

I understand if I am experiencing seizures or have a history of seizures, I must have another trusted adult present during my sessions should I require immediate attention.

I Agree

Float Therapy

I recognize that I have or will watch the Introductory Video provided by VIVE Float Studio + (online or onsite) in advance of my first VIVE Float Studio + float and will receive very basic verbal instructions during my initial tour about the use and process of the float room. I understand that the Instructional Video and this written waiver are to serve as the primary source of information and education of the use of the float rooms, entering and exiting the float rooms using handrails, and the grounds and facility.

I Agree

I recognize that I have or will watch the Introductory Video provided by VIVE Float Studio + for proper use of the earplugs. I understand that the earplugs are not designed to be inserted into the ear canal.

I Agree

Should I have an emergency situation while inside the float room I am aware that there is a two-way intercom system that I can use to request assistance as shown in the Introductory Video.

I Agree

I understand that I cannot float if I have dyed my hair within 48 hours or if any color/dye remains on a white towel. While it will not hurt my hair, the dye could discolor and contaminate the salt water, resulting in a $500 fee.

I Agree

I agree to abide by the 5-minute mandatory shower using the provided wash cloth to exfoliate and remove natural oils, lotions, deodorants, hair products, etc. even if I showered prior to arriving at VIVE Float Studio +. I will honor the 5-minute shower rule to avoid a $500 fine.

I Agree

VIVE Float Studio + takes the cleanliness and sanitation of our water so seriously that they have chosen to enforce a $500 fee for anything left in the float room water or as mentioned above, should a person skip the mandatory 5-minute shower. Please be advised that due to the density of the salt, it is very evident if anything is left behind. Each client should use the float facility with the utmost respect for the next client by honoring the water sanitation guidelines.

I Agree

I understand that at 66-minutes the float room light will come on notifying me that my float session is over. At that point I will exit the float room to begin my post float shower. If the staff does not hear the shower running they will attempt to communicate via the float room two-way intercom system. Should you not respond, please be aware that a staff member will knock on the outside door attempting to wake you. Only after 1) the float room light has come on, 2) the float room jets have come on, 3) we have utilized the intercom, and finally 4) knocked on the outside door will we enter the room to wake/inform you that your session is over. If we must enter the room we will enter with an objective to honor your privacy.

I Agree

CryoTherapy

During the session, you must ensure that your head remains above the level of, and avoid inhaling, gasiform air (the cloudy gas circulating in the cryochamber); while non-toxic, it is devoid of oxygen and may cause shortness of breath, fainting, or other conditions;

I Agree

You must immediately notify the attendant and end the session if you at any time experience any physical or mental discomfort, problems, pain or anxiety;

I Agree

Abnormal skin sensitivity to cold may be caused by lotions, piercings, or medication, including but not limited to, tranquilizers and high blood pressure medication – do not use CryoTherapy if you have reason to believe you have come in contact with or ingested any such product.

I Agree

Whole Body Cryotherapy Contraindications

Do not use whole body cryotherapy if you have or may have any of the following conditions:  Pregnancy, Stage 2 Hypertension (BP> 160/100) according to American Heart Association, acute or recent myocardial infarction, unstable angina pectoris, arrhythmia, symptomatic cardiovascular disease, cardiac pacemaker, peripheral arterial occlusive disease, venous thrombosis, acute or recent cerebrovascular accident, uncontrolled seizures, Raynaud’s Syndrome, fever, tumor disease, symptomatic lung disorders, bleeding disorders, severe anemia, infection, claustrophobia, cold allergy, age less than 18 years (parental consent to session needed), acute kidney and urinary tract diseases.  If you have any other injury, illness or medical condition, you should consult your physician prior to using cryotherapy.

I Agree

Risks of whole body cryotherapy include but are not limited to:  fluctuations in blood pressure (due to peripheral vasoconstriction, systolic blood pressure may briefly increase by up to 10 points during the session.  This effect should reverse after the end of the session, as peripheral circulation returns to normal), allergic reaction to extreme cold (rare), claustrophobia, anxiety, activation of some viral conditions (cold sores) etc. due to stimulation of the immune system. One primary inherent risk of cryotherapy is skin sensitivity and skin irritation. It is impossible to predict how client’s skin will react during or after cryotherapy.

I Agree

Spot Cryotherapy Contraindications

Do not use Spot Cryotherapy if you have or may have any of the following conditions:  Cryoglobulinemia, Cold hemaggulation or cold hemolysis, cold-induced itching, impaired arterial blood flow as from stage II, Raynaud’s Disease, severe sensory disorders, trophic disorders, hypersensitivity to cold.  If you have any other injury, illness or medical condition, you should consult your physician prior to using spot cryotherapy.

I Agree

HaloTherapy

HaloTherapy (“Salt Therapy”) is not recommended in the following cases: tuberculosis, fever, contagious conditions, severe heart disorders, or existence of cancer, advanced pregnancy, or acute state of respiratory attack.

I Agree

I have been advised of the following possible side effects: Dry or itchy throat, nasal drip, and increased coughing at the beginning. This is a natural part of the cleaning process of the respiratory system, during which the pollution, accumulated through a long time, and now loosened up by the salt, are expelled from the lungs.

I Agree

Vibroacoustic Therapy (VAT)

Before using VibroAcoustic equipment, it is recommended you should consult the advice from your doctor under the following situations.

- If you currently suffer from deep vein Thrombosis.

- Immediately after an accident resulting in a Whiplash injury.

- If you show signs of internal or external bleeding, shortly after an operation, or if bleeding may be started by low-frequency sound massage. (This does not apply to menstrual bleeding).

- If you suffer from hypotension (low blood pressure), as Vibroacoustic sessions may aggravate already low blood pressure.

I do not have any of the above conditions.

I Agree

I DO NOT HAVE A PACEMAKER AND UNDERSTAND THAT SERIOUS REPERCUSSIONS CAN OCCUR IF A PACEMAKER COMES IN CONTACT WITH THE VAT.

I Agree

Infrared Sauna

I agree it is recommended to discontinue the use of the sauna if I feel light-headed, dizzy or heat exhausted.

I Agree

I understand it is always important to maintain proper hydration levels during infrared therapy. We recommend drinking a minimum of 8 oz. of water prior to entering the sauna and minimum of 24 oz. of water after sauna use.

I Agree

I DO NOT HAVE A PACEMAKER AND UNDERSTAND THAT SERIOUS REPERCUSSIONS CAN OCCUR IF A PACEMAKER COMES IN CONTACT WITH THE INFRARED.

I Agree

First Client's Name

First Name*

Last Name*

Phone*
First Client's Date of Birth*
First Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
First Client's Signature*
Second Client's Name

First Name*

Last Name*
Second Client's Date of Birth*
Second Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Third Client's Name

First Name*

Last Name*
Third Client's Date of Birth*
Third Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Fourth Client's Name

First Name*

Last Name*
Fourth Client's Date of Birth*
Fourth Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Fifth Client's Name

First Name*

Last Name*
Fifth Client's Date of Birth*
Fifth Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Sixth Client's Name

First Name*

Last Name*
Sixth Client's Date of Birth*
Sixth Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Seventh Client's Name

First Name*

Last Name*
Seventh Client's Date of Birth*
Seventh Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Eighth Client's Name

First Name*

Last Name*
Eighth Client's Date of Birth*
Eighth Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Ninth Client's Name

First Name*

Last Name*
Ninth Client's Date of Birth*
Ninth Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Tenth Client's Name

First Name*

Last Name*
Tenth Client's Date of Birth*
Tenth Client's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Client's Address
Address Line 1:
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:
City:
State/Province:
Zip/Postal:
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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How did you hear about us? (floatation locations, VIVE Website, Yelp!, Google, Instagram, Facebook, TripAdvisor, etc)
How would you like to receive future appointment confirmations*
Mobile Phone
Home Phone
Email
If you selected "Mobile Phone" please let us know who your carrier is.*
AT&T
T-Mobile
Verizon
Other

If you selected "Mobile Phone" please leave us a cell phone number where you can be reached.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
What brought you to VIVE Float Studio? Please let us know some of your reasons for floating.This information, while confidential, helps us find commonalities between our clients in order to fine-tune our services and benefits.
Athletic Recovery
Injury Rehabilitation
Accelerated Healing
Stress
Neck Pain
Arthritis
Joint Swelling
Sleep Disorder
Post-Surgery
Auto-Immune Issues
Pregnancy
Back Pain
Relaxation/Meditation
Visualization
Anxiety
Addiction
Other

If you selected "Other" please note what brings you in
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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