Dear Guest,
in order to ensure your complete comfort and health throughout your visit with us here at CRYO, Stay Young Spa, we ask a brief moment of your time to fill in the following health questionnaire.
Please note:
We will retain this information in our files only for the duration of your treatment. This information will remain in strictest of confidence abiding by the rules and regulations for the protection of your privacy.
Thank you for your cooperation.
CRYO Management
To ensure you get the best result from your session of oCRYO Whole Body therapy, please ensure that your body is completely dry and free from any creams or oil residue.
Please note that should you not be comfortable to withstand the low temperatures, you are free to end your session at any time during the treatment by simply opening the door and stepping out. A oCRYO technician is always present with you to guide and assist you throughout your session.
Health Assessment Acknowledgement
Fluctuations in blood pressure (due to peripheral vasoconstriction) blood pressure may briefly increase by up to 10 points
Reply Questions: YES/NO
Cardiovascular Conditions
Circulatory
Blood Disorders
Other Conditions
General Health
Ladies Only
RELEASE AND WAIVER OF LIABILITY
1. In consideration for using the whole body cryotherapy, I hereby release, waive, discharge, and hold harmless, oCRYO Health, it’s officers, agents, employees and volunteers from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury that may be sustained while using the equipment or due to the use of the equipment. I hereby confirm that no warranty or guarantee, or other assurance, has been made to me covering the results of the cryotherapy treatment, and I hereby relieve oCRYO Health 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 administration of the process. I am fully aware of the risks and hazards connected with the use of the whole body cryotherapy, including the risk of physical injury. I am voluntarily participating in the use of the treatment. and voluntarily assume full responsibility for any risk of loss, property damage or personal injury that may be sustained, or any loss or damage to property as a result of being engaged in such an activity. It is my express intent that this Waiver and Release Liability Agreement shall bind the members of my family and spouse (if any), if I am alive, and my heirs, assignees and personal representative.
If I am not alive, and shall be deemed as a RELEASE, WAIVER AND DISCHARGE of the above. I hereby further agree that this Waiver and Release Liability shall be construed in accordance with the laws of the UAE. I understand that oCRYO Health will not be responsible for any medical costs associated with any injury and understand that whole body cryotherapy is designed for fitness and appearance enhancement purposes and is to be used only by persons in good health. I have been advised that if I suffer form any medical condition or illness whatsoever, I am not to proceed with the treatment without my doctor’s written permission.
My signature below constitutes my acknowledgement that (1) I have read, understand and fully agree to the Waiver and Release Liability Agreement, (2) the whole body cryotherapy process has been satisfactorily explained to me and I have all the information I desire and (3), I hereby give my authorization and consent to oCRYO Health to proceed with the treatment as explained to me. This Waiver and Release Liability Agreement shall stand as long as I use the equipment at the location now and in the future. I have read the instructions for proper use of the facilities and do so at my own risk and hereby release the owners, operators, or franchisers, from any damage or harm that I might incur due to the use of facilities.
IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read and understand the Waiver and Release Liability Agreement. I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate, and complete consideration fully intending to be bound by same. Furthermore, I agree that I will comply with all instructions on the use of the equipment and that I am using these services at my own risk. I agree to use all sessions within the terms of the contract dates and understand that refunds are not given on unused portions of purchased packages.
