THE LOFT BEAUTYBAR & MEDSPA
Please fill out your
Personal & Confidential
Before your visit
These are mandatory forms
Our policy is to inform you to the best of our ability. Our policy also includes the measures we are actively taking to mitigate the spread of coronavirus. You are kindly requested to follow all these rules diligently, to sustain a healthy and safe workplace in this unique environment.
I understand that The Loft Beauty Bar and Medspa intends to utilize the Cocoon Wellness Pro System to provide me with sauna (heat) and vibratory massage services for the promotion of relaxation, general wellness and fitness. I hereby give my consent to the facility and its staff to provide wellness services for these purposes. I further understand that members of the staff do not diagnose illness or disease or any other physical or mental disorder. I understand that sauna (heat) and vibratory massage therapies are not substitutes for medical examinations or treatments. I have been advised to consult with my personal physician for any ailments that I may be experiencing. I acknowledge that no assurance or guarantee has been provided to me as to the results of services provided by the facility. I hereby agree that the facility will not be liable for any injury to me resulting from my use of the Cocoon Wellness Pro System and I herby forever release the facility from any and all claims, demands, damages or causes of action resulting from said use.
Contraindications for use of the Cocoon Wellness Pro System:
(MAX HEIGHT: 6ft 9in MAX WEIGHT: 350lbs)
|Use of the Cocoon Wellness Pro System is not recommended for individual with the following conditions||Individuals with the following conditions are advised to obtain physician consent before using the Cocoon Wellness Pro System|
● Active Cancer
● Broken bones or slipped disc
● Infections/contagious skin conditions; skin lesions, abrasions and/or areas of inflammation/persistent erythema
● Outfitted with pacemakers or defibrillators
● Individuals running a fever or insensitive to heat (ie: erythema ab igne)
|● Pregnancy or lactating
● Heart disease and/or cardiovascular conditions
● Using medications such as diuretics, barbiturates, anticholinergics, and/or beta blockers
● Hemophiliacs/Individuals prone to bleeding
● Individuals with implants (metal, breast, etc)
● In poor health
I understand that the staff must be made fully aware of existing medical conditions, if any. I also understand that prolonged exposure to heat can lead to dry skin. I have been advised that it is important to hydrate before and after heat sessions to insure against dehydration, and that for high heat sessions I should initially use a comfortable heat level and gradually increase the head level as my body acclimates or adjust to the higher cabinet temperatures.
The information I have provided is true and complete to the best of my knowledge. I have read this Informed Consent and Release Form and I have had the opportunity to ask questions about the contents and my treatment. By signing this Informed Consent and Release Form, I affirm my consent to treatment and intend this consent to cover the services discussed with me and such additional services as requested by me from time to time. I understand that at any time I may withdraw my consent and further services will be discontinued.
HYDRATION is key. Please be sure you have consumed 8 – 12oz of water before your session.
Note if you are coming in for power nap, relaxation, anti-stress and anxiety relief treatment to calm the nervous system and bring full body wellness you can wear your clothes (Gym / Lounge attire) in the pod. Please make sure you do not have any brand new clothing on that hasn’t been washed yet so that the colour does not transfer onto the cocoon mattress.
To be the happy place for your face, body & hair. To be the place you look forward to coming. We pride ourselves on being a safe, fun & judgement free environment.
4407 Montrose Rd
Niagara Falls Ontario