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We are thrilled that you are interested in participating in our infrared sauna, cold plunge, red light therapy, and compression boot services. This participation involves exposure to extreme temperatures (i.e. hot and cold). All NEW clients must have a Unify representative in attendance to assist you during your first visit. At any time you feel uncomfortable with participation, are unwell, or for whatever personal reason, you feel the need to stop, you may cease participation immediately. 





LIABILITY AND MEDICAL RELEASE/INDEMNIFICATION AGREEMENT

After clearance by Unify to participate in their services, I hereby waive any and all claims for damages for personal injury or death which may occur as a result of my participation. I understand and agree that:

1. This release is intended to discharge in advance UNIFY, its owner, employees, and volunteers against all liability arising out of or connected in any way with my participation in these activities.

2. Participation may involve the risk of serious injury, illness, or disability 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 Unify owner, employees, volunteers, and may result from the conditions of the facilities, equipment, or areas where such activities are being conducted.  

3. In understanding and knowing the risks involved, I voluntarily have chosen to participate in the activities and services provided by Unify. 

4. I will indemnify and hold harmless Unify, its owner, and employees, of any cost or expense, including litigation of any form, arising out of or connected in any way to my participation in activities and services provided by Unify. 

5. I am in good health and have non of the aforementioned conditions listed above which would preclude me from participating in these activities. 

6. I understand and agree that this release is intended to be broad and inclusive as permitted by the law of the State of Arizona or the jurisdiction in which it was executed. If any portion of this agreement is determined to be invalid in that jurisdiction, it is my intent that the remaining provisions shall continue in full force and effect. 

I HAVE FULLY READ AND ANSWERED TO THE BEST OF MY ABILITY THE QUESTIONS STATED ABOVE. I AM AWARE THIS IS A RELEASE OF LIABILITY AND A POTENTIAL CONFLICT BETWEEN MYSELF, MY HEIRS, AND UNIFY. I VOLUNTARILY AGREE TO EACH OF THE TERMS. 



First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Have you had any type of cardiac event in the past 2 years?
Click to customize question*
No
Yes
Do you have undergone any cardiac related procedure or surgery?
Click to customize question*
No
Yes
Do you have a pacemaker?
Click to customize question*
No
Yes
Do you have congestive heart failure?
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No
Yes
Do you have an intrathecal pain pump or electro stimulation implant?
Click to customize question*
No
Yes
FEMALES: Are you pregnant? Extreme temperatures, red light therapy and compression therapy are highly discouraged unless you've received approval from your medical provider.
Click to customize question*
No
Yes
Females: I understand that I may not participate in the cold plunge portion while on menstrual cycle. A failure to comply may lead in a $150 cleaning fee.
Click to customize question*
No
Yes
Do you have a history of seizures or fainting?
Click to customize question*
No
Yes
Do you currently have any open wounds or sores? If yes- please refrain from cold plunge participation. A $150 cleaning fee will be applied if failure to do so.
Click to customize question*
No
Yes
Do you have any known allergies or skin reactions to extreme hot or cold?
Click to customize question*
No
Yes
Do you have any diagnosed blood disorders? (i.e. blood clotting/hemophilia)
Click to customize question*
No
Yes
Do you have any major circulatory dysfunction? (i.e. DVT)
Click to customize question*
No
Yes
Are you currently under the influence of drugs (recreational or prescription)?
Click to customize question*
No
Yes
Have you consumed alcohol in the last 6-8 hours?
Click to customize question*
No
Yes
Do you currently have any of the symptoms of a blood clot: include symptoms
I acknowledge I do not have any of the following conditions: Acute pulmonary edema Acute thrombophlebitis Acute congestive cardiac failure Acute infections Deep vein thrombosis (DVT) Episodes of pulmonary embolism Wounds, lesions, infection, or tumors at or near the site of application Where increased venous and lymphatic return is undesirable Bone fractures or dislocations at or near the site of application. (compression boot therapy)
Click to customize question*
No
Yes
FAQs for Light Therapy Treatments Joovv uses only the red and near infrared wavelengths that are clinically-proven to be effective and safe. However, we always recommend consulting with your healthcare provider for specific questions about your health conditions.
Click to customize question*
No
Yes
Contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person. Do not use the device if you are photosensitive. Do not use the device if using topical, oral, or injectable steroids. Do not use the device during the healing period post Lasik eye surgery. Do not use the device if pregnant or lactating, users should consult their physician with any questions. I do not currently have any contraindications.
Click to customize question*
No
Yes
Precaution is a measure taken in advance to prevent something dangerous, unpleasant, or inconvenient from happening. Red and Near Infrared (NIR) light can aid detoxification symptoms, make sure to follow treatment guidelines list in this manual. Near Infrared (NIR) at 850 nm may aid hyper-pigmentation; discontinue use if this is a concern. Post-surgery users should consult a physician prior to use. Users who have had laser hair removal could experience hair regrowth. Users with cancer or history of cancer should consult their physician prior to use. Users with pre-existing health conditions should consult their physician prior to use. Users with hyperthyroidism should consult with their physician prior to use, as use could increase symptoms. Users with black pigmented tattoos could experience skin blistering. Blistering can occur by inadvertent heating of the iron oxides and/or the metal salts in the tattoo’s black pigment. Tattoo locations can be covered prior to your treatment. Users with herpes virus could experience activation of dormant virus with use. Users taking medications such as Tetracycline, Digoxin, Retin A, and/or other photosensitive drugs, are recommended to consult with your healthcare provider prior to use. Users with a history of facial fillers and Botox injections should consult their dermatologist prior to use. Users with breast implants should consult their plastic surgeon prior to use. I acknowledge the precautions and have or will consult with my healthcare provider.
Click to customize question*
No
Yes
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.


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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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