Initial consultation form.

To help us create the best possible plan for your treatment, please answer the following questions as fully as possible. If any answer is “YES” please provide more information including when it occurred, severity level, any medication, dose and how long you have been taking it for.

Please allow 15-20 minutes to fill out the form below and ensure you have completed this a minimum of 24 hours before your session with us. If you are unable to complete this form for any reason please give us a call on 0272357100 to discuss. Failure to complete this form will result in your session being cancelled and you will be charged 100% of the session cost.

ENVIRONMENTAL CONSIDERATIONS: Please answer YES or NO to the following questions, if you answer yes please tell us a little more about your work or home premises and your daily living association to EMF (ElectroMagnetic Field) transmissions.

To optimize your experience there are a few things we would like to share:

As we do not have a shower on our premises please ensure that you are showered and fresh, wearing comfortable clothes to your session. Parking is located outside the front windows of our building please feel free to park there.

Please note: 48 hour notice must be given to transfer the session to another date. Alternatively, any less then 48 hours notice will incur a charge of 50% of the total session cost and any less then 24 hours will be charged at 100% of the total session cost.

Also, we have a friendly and furry four legged team member here: Caesar the British Bulldog. Don’t let his staunch look fool you, the only things he loves more than Hyperbaric Oxygen is cuddles and a pat! If for any reason you do not feel comfortable with him being present, please let us know and we will make sure he takes the day off.

Thank you for taking the time to complete this form.
We look forward to seeing you.

Ready to start your Hyperbaric Oxygen Therapy journey?