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Areté Float Tank & Personal Optimization Studio

Waiver & Professional Agreement 

We want you to have an amazing and safe experience with us and request that you be aware of and agree to the following information and policies:

Facilities: Amenities provided include: Towel, washcloth, ear plugs, shampoo/body wash, and shower. It is up to each individual to take caution to prevent slipping or falling as floor surfaces may be wet even though it is slip resistant. The facility is cleaned between each session. Additionally, the tank is fully filtered and sanitized between each session in accordance with the floatation tank community standards as well as North Carolina Health Code.

Fees: Float sessions are up to 90 minutes. Fees vary based on the desired service package and practice commitment. These fees are subject to change. We require payment for services at the time of service.

Cancellation Policy: You must cancel scheduled sessions 24 hours in advance; otherwise, we may bill you for 100% of the normal session fee, even if the cancellation was unavoidable (currently enrolled members are exempt from this policy)

I Agree that I WILL NOT float:

  • If I have not adequately showered to remove all dirt, sock lint, skin & hair products, cosmetics ect.
  • If I have any communicable or infectious diseases or illness’, skin disorders, large cuts, open sores, or wounds.
  • If I have used a self tanner or had a professional spray tan in the past 72 hours.
  • If I have recently (in the last 14 days) had my hair dyed at home or professionally.  Rule of thumb: if the water runs clear when you shower, you're good to float! 
  • Without consulting my physician if I am taking medication under frequent physician's care, or have a history of heart trouble, kidney trouble, diabetes, schizophrenia, epilepsy, seizures, blackouts, or adverse reactions to deeply relaxed states and/or magnesium.
  • If I have incontinence, or voluntarily/involuntarily release of bodily fluids of any kind.
  • Under the influence of alcohol, and/or illicit drugs.
  • If I am unable to safely enter and exit the pod alone or am without assistance present during the duration of the session
  • If I am under 18 without the presence of a parent or guardian on premise for the duration of the session.

​I AGREE:

  • To shower thoroughly before floating and to only use the products that are provided by the facility.
  • And acknowledge that use of scented products such as perfume, body sprays, muscle rubs, or burning incense are prohibited.

​I Understand That:

  • I understand that Areté Float Tank and Personal Optimization Center, LLC reserves the right to refuse service to anyone.
  • I am choosing to use floatation therapy of my own free will and will not hold the owner/operator or Areté Float Tank & Personal Optimization Studio, LLC liable for any injury during a session or while on the premises.
  • The Floatation Tank contains Pharmaceutical grade Magnesium Sulphate, Water, and Bromine (2ppm) as ordered by the NC Health Department , and that some people may experience skin allergies, discomfort or other reactions to this solution.
  • A cleaning fee of $1000 will be applied if an incident caused by myself occurs damages relevant to conditions stated herein, additionally to compensate Areté Float Tank & Personal Optimization Studio, LLC for any lost revenue because of incident of water contamination from hair dye, tanning products, and/or bodily fluids, or any other breach of conditions stated herein.
  • This signed document represents an agreement between us, which you may revoke in writing at any time.

​I understand that the float tank solution is not discarded between floats, but is filtered, sanitized and recycled; that our tanks are inspected between every single float; and that violation of any of these rules that results in contamination of the float tank solution may result in a cleaning or salt replacement fee of $200-$1000.

Today's date: June 28, 2022

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
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.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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

Intake Form

Please fill out completely. We will never share your information with anyone without consent, for any reason.


Occupation:

How did you hear about us?

What areas of your life do you hope floating will help improve? Check as many as needed 

CLINICAL GOALS:
Stress Relief
Reduce Stress-Related Illness
Depression Relief
Anxiety Relief
PTSD Symptom
Fibromyalgia Relief
Eating Disorder
Eliminate Addictive Behaviors
PHYSICAL GOALS:
Increased Energy
Alleviate Physical Pain
Athletic Enhancement
Rapid Physical Recovery
Headache Relief
Lower Blood Pressure
Improve Sleep Quality
Speed Jet-Lag Recovery
MENTAL GOALS:
Increase Motivation
Improve Concentration
Improve Problem-Solving
Increase Creativity
Increase Intuition
Meditation Practice
Personal Growth
Elevate Mood

Any additional therapy goals not listed above:

If experiencing physical pain, where is this pain:

What do you currently do to alleviate the above concerns?

List anything that has not worked for you:
Are you currently taking any medications, supplements, or vitamins?*
No
Yes

If yes, what and how often?

Please list any additional medical conditions:
Have you shaved/ waxed in the last 36 hours?*
No
Yes
Do you wear contacts:*
No
Yes
Have you ever floated before:*
No
Yes

If 'yes', when was the last time & where:

Tell us about your last experience (good, bad, magical, etc):

Are there other Therapies/ services you would like offered here?
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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