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SSH Health Waiver

Please fill out the following form.

Date of birth
Day
Month
Year

Please answer each question carefully to ensure your Health & Safety

1. Do you have any electronic devices attached to your body such as pacemaker, diabetes tag etc
No - please proceed
Yes - I will cancel my booking
2. Do you have a severe heart condition, epilepsy or other seizure disorder or serious Mental Health Disorder?
No - please proceed
Yes - I will cancel my booking

Vibrations and frequencies can trigger seizures, interfere with electronic equipment and can also exacerbate serious conditions. You should not proceed with your booking.

3. Do you weigh more than 20 stone/127k/220lbs
No - please proceed
Yes - I will cancel my booking

Our blue beds take up to 16 stone and our green beds can take up to 20 stone. Please select a suitable bed for your size on arrival.

4. Are you currently pregnant?
No - please proceed
Yes - I will cancel my booking

There is limited research on the effect of vibration on unborn babies. As safety of our guests is of the utmost importance, we choose not to accept Guests who are pregnant

Please Self Assess your own capabilities as accurately as posssible

5. Can you swim? - you do not need to swim as you will not be entering the water. Lifeguards are on duty
No - please ensure you identify yourself to staff and collect a flag to ensure you are kept in the shallow end
A little - if you are anxious please identify yourself to staff who will give you a flag to ensure you stay in the shallow end
Yes
6. Can you mobilise down to floor level and get back up again?
No - please ensure you have a buddy with the relevant aids to assist you
A little - staff will assist you
Yes
7. Do you suffer from tinnitus or other sound related conditions or are you prone to motion sickness/nausea?
No
Yes - if you feel uncomfortable at any point, RAISE your ARM and staff can move you to the shallow end or continue your session at the side of the pool
8. Do you have any allergies?
No
Yes - managed with medication
Yes - I have checked that the experience is suitable for me

Please read and tick to agree the following:

Thank you for booking with Somatic Soundwave Healing and taking the time to complete our Health Waiver. We are really looking forward to looking after you for a while....


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