Your details

Full Name *

Address *

City *

Postal code *

Email *

Phone *

Date of birth *

Occupation *

Emergency Contacts

Emergency Contact Name

Emergency Contact Number

Medical Info - this information is needed

Please list details for any of the above conditions that apply to you

description

(Please tell us more about the conditions you have ticked in the boxes above)

Tell us why you are here!! What do you want from this session? *

How did you find out about us (so we know who to thank if you were recommended!!) *

I confirm when using the facilities at Time to Float, and having been briefed on any activity i have chosen, i do so at my own risk.

Floatation - I am not wearing a pacemaker and do not have any serious heart disease. I do not suffer from epilepsy, schitzophrenia or psychotic attacks, acute skin disorders or very low blood pressure.

I am not under the influence of drugs, alcohol or illegal substances.

Please note: there will be upto a £1250 cleaning fee if bodily fluids are excreted in the pod, or hair dye runs into the water

Infra red Sauna - we do not recommend to use if you are in the first trimester of a pregnancy. Please consider medical advice if you suffer Kidney disease or unstable angina pectoris.

Cold Water immersion - Please consider medical advice if you suffer with heart issues, blood pressure, or other circulatory issues.

Pneumatic compression therapy - We do not recommend if you have open wounds or leg ulcers. Please consider medical advice if you suffer peripheral vascular disease.

Ionic Foot Detox - we do not recommend this treatment if you have a heart pacemaker, or have had an organ transplant.

I certify that the information is correct to the best of my knowledge.
I will not hold Time to Float, or its employees, responsible in any way for errors or omissions thaat i have made in the completion of this form.

I accept all liability where information was held back that could have been relevant to my treatment.

I understand that all treatments provided by Time to Float are designed to be alternative healthcare treatments. they are not designed to take the place
of Doctor's care, but to act as a supplemental care package.

I will not attempt to float after recently dyeing my hair, or applying hair treatments such as keratin. I understand that if i do without providing Time to Float this information that i will not hold them liable for any potential damage that the session may or may not occur.

All client/practitioner information is confidential. To conform with GDPR regulations you agree that by accepting these terms your details will be stored in our database.

I agree to abide by these terms and conditions provided by the company. By providing my phone number, I agree that i may receive text messages from Time to Float in the future.

Client Signature *

date of signature *