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DEFINITION: Whole Body Kriotherapy - is the process of the body being exposed to extremely low temperatures causing rapid shunting of the circulation from the periphery to the core for a limited time (i.e. 2-3 minutes) at which time the client is removed from the exposure to allow for rapid vasodilation and therefore detoxification from the subcutaneous layers. 

HOW: The temperature in the body's core must be constant and equal to -98.6°F. So upon receipt of signals from the skin's cold sensors activated by the kriotherapy whole body chamber, the brain center has a clear warning that maintaining the necessary core body temperature will be impossible if blood circulation in the outer layers of the skin is allowed to continue. Therefore, all survival resources are mobilized, and blood is sent into the body's core to begin circulating in an "internal cycle" to protect the vital organs. An immediate effect includes an increase in the arterial blood pressure by about 10 points. For example, if the systolic pressure (upper number) was 130 points (or millimeter of mercury) before the treatment, it may reach 135-140 afterwards for a short time. 

CONTRAINDICATIONS: Pregnancy, severe Hypertension (BP> 180/100), 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, cold allergy, acute kidney and urinary tract diseases. 

I authorize to participate in session(s) of whole body kriotherapy. I understand that it may cause a temporary increase in systolic blood pressure and I'm stable enough to tolerate the increase without adverse reaction.


WAIVER, RELEASE, CONSENT 

This release clears in advance Kriobox: its officers, employees from and against any and all liability connected in anyway with my visit to Kriobox. 

• I have had all questions and concerns answered 

• I hereby confirm that no warranty or guarantee has been made to me as a result of kriotherapy, and I hereby release, indemnify and hold harmless Kriobox, its officers, employees, 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. It is understood that this consent is being given in advance of any processes, and is being given by me voluntarily. 

• I understand that any moisture, metal or synthetic material on my person will increase chance of any mishap. 

• participation may involve risk of serious injury, illness, disability or death and may result not only as a result of my actions, negligence or inaction, but also from the action, negligence or inaction of others, including owners, officers or other bystanders. 

• I am fully aware of all risks involved and the contraindications related, I nevertheless chose voluntarily to request permission to participate 

• I will release and hold harmless Kriobox, its owners, officers, employees from any loss, liability, damage, cost or expense, including litigation of any form, arising out of or connected in any manner with my participation in such activities. I assume full responsibility for any risks of loss, property damage or personal injury that I or my property may sustain 

• I am in good health and have no condition which would preclude me from safely participating. 

• I understand and agree that this release is intended to be as broad and inclusive as permitted by law. It is my expressed intent that this Release and Hold Harmless Agreement shall bind the members of my family (& spouse), heirs and personal representatives. Shall be deemed as a release, waiver and discharge of all family, friends and business associates. I understand Kriobox will not be held responsible for any medical, cosmetic or emotional costs associated with any injury. 

• I understand and agree that kriotherapy is not intended to diagnose or treat any specific disease and that i have had all my questions answered before participating in kriotherapy. I acknowledge I am not to use kriotherapy if I have any health issues without my doctor's written permission. 


• In signing this release, I am agreeing I have read, have had all my questions answered and understand the process and have all the information I desire. I am at least eighteen (18) years of age and fully competent: and I execute this document for full, adequate, and complete consideration fully intending to be bound by same. I am using Kriobox services at my own risk. 

I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A POTENTIAL CONFLICT BETWEEN MYSELF & MY HEIRS AND KRIOBOX. I VOLUNTARILY AGREE TO EACH OF THE TERMS AND PROVISIONS HERIEN AND SIGN THIS OF MY OWN FREE WILL 

March 12, 2026

Please select who will be participating...
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First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Information
Gender: *

Health History Questionnaire


Are you pregnant?*
Has your doctor ever said you have a heart problem?*

Do you have any of the following: 

Severe Hypertension (BP 180/100)
Acute or recent myocardial infarction
Unstable angina pectoris
Symptomatic cardiovascular disease
Cardiac pacemaker
Peripheral arterial occlusive disease
Venous thrombosis
Acute or recent cerebrovascular accident
Raynaud's syndrom
Fever
Tumor disease
Symptomatic lung disorders
Bleeding disorders
Severe anemia
Infection

Do you have any of the following conditions:

Epilepsy
Emphysema
other Lung disease

Have you ever experienced any of the following:

Pain in your chest
Dizziness or fainting
Shortness of breath
Do you currently take any medications?*

If Yes, please list:

I hereby certify that I have answered the above questions to my best knowledge, and I understand that the information will be used to determine appropriate screening and testing before entering the Kriobox. 

First Participant's Signature*
Participant'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*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
I acknowledge that i have read and understand the kriobox waiver, release, consent acknowledge health history and Authorization and risk associated with kriotherapy.My son/daughter has also read and acknowledged the contraindications and waiver or risk. I give consent on behalf of my minor to voluntarily undergo treatment:


By signing below the parent or court-appointed legal guardian agrees that they are also 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*
Date of Birth
Information
Gender: *

Health History Questionnaire


Are you pregnant?*
Has your doctor ever said you have a heart problem?*

Do you have any of the following: 

Severe Hypertension (BP 180/100)
Acute or recent myocardial infarction
Unstable angina pectoris
Symptomatic cardiovascular disease
Cardiac pacemaker
Peripheral arterial occlusive disease
Venous thrombosis
Acute or recent cerebrovascular accident
Raynaud's syndrom
Fever
Tumor disease
Symptomatic lung disorders
Bleeding disorders
Severe anemia
Infection

Do you have any of the following conditions:

Epilepsy
Emphysema
other Lung disease

Have you ever experienced any of the following:

Pain in your chest
Dizziness or fainting
Shortness of breath
Do you currently take any medications?*

If Yes, please list:

I hereby certify that I have answered the above questions to my best knowledge, and I understand that the information will be used to determine appropriate screening and testing before entering the Kriobox. 

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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