What specific health risks or sensations should I include in the Hyperbaric Oxygen Consent Form?

You should include sections for clients to acknowledge common physical effects like ear pressure changes, potential sinus congestion, and the necessity of reporting any claustrophobic feelings during the session.

Can I add a field to this form that tracks if a client has undergone recent surgery or has specific medical hardware?

Yes, you can easily add custom text blocks or checklist fields to your Hyperbaric Oxygen Consent Form to verify the absence of contraindications like recent ear surgery or implants that might be sensitive to pressure.

What is the best way to present this consent form to clients right before they enter the oxygen chamber?

The most efficient method is to set up a tablet in your lobby or waiting area in kiosk mode, allowing clients to read and sign the form digitally immediately before their appointment.

Can I attach specific aftercare instructions to this consent form for clients to review after the session?

Absolutely, you can append a page to your form that details post-session care, such as hydration or monitoring for temporary vision changes, and require a secondary signature acknowledging those care steps.

How can I automatically organize these signed forms once a client completes the process?

All submissions are stored in your dashboard where you can filter them by date, client name, or service type, allowing you to quickly pull up a signed form if you need to double-check a client's acknowledgment of your safety protocols.

Hyperbaric Oxygen Consent Form

This Hyperbaric Oxygen Consent Form is designed for wellness clinics and spas to document that clients acknowledge the specific physical sensations and safety protocols involved in oxygen therapy sessions.

Created by Stacy Wu · Content specialistUpdated Jun 20, 2026

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Consent

Hyperbaric Oxygen Consent Form

By signing this document, you confirm that you have read and understood the nature of the Hyperbaric Oxygen Therapy sessions provided by our wellness facility. You are providing your informed consent to participate in these pressurized sessions and acknowledge that you understand the basic requirements of the treatment process.

You acknowledge that you have been fully informed regarding the nature of Hyperbaric Oxygen Therapy (HBOT), including the physiological effects of breathing pressurized oxygen, the necessity of equalizing ear and sinus pressure, and the specific contraindications that may render HBOT unsuitable for your health profile. We have provided you with a clear explanation of what to expect during a session and have allowed you sufficient opportunity to ask questions regarding your treatment plan. By signing below, you confirm that you have been made aware of the typical sensations and potential challenges associated with the chamber environment, and you voluntarily choose to proceed with these sessions having been informed of the clinical considerations involved.

You grant us permission to use any photographs or video footage captured during your time at our facility for our business records, internal training, and promotional materials, such as our website or social media channels. Furthermore, you consent to the collection and use of the personal and health-related information provided on this form for the purposes of administering your therapy, maintaining accurate clinical records, and contacting you regarding your scheduled appointments and session follow-ups.

Participant details

Full legal name*

First name

Last name

Email address*

Phone number

Date of birth*

Reason for therapy

Are you currently experiencing cold or flu symptoms?*

Yes

Do you have any implants or metal devices?

Agreement & signature

I confirm that I have read this document in its entirety, I understand the terms of this informed consent, and I am signing this agreement voluntarily. I represent that I am at least 18 years of age and possess the legal authority to sign this document on my own behalf.

I have read and give my consent as set out in this form.*

Signature*

Sign here

Date*

Parent / guardian (minors under 18)

Minors: under 18 years of age

Parent / legal guardian printed name

First name

Last name

Relationship

Parent / legal guardian signature

Sign here

Date

About this template

The Hyperbaric Oxygen Consent Form is a digital document designed to help beauty and wellness studios collect participant acknowledgement for oxygen therapy sessions. You can customize the template with your studio's branding, including your logo and business colors, to ensure a professional look for your clients.

Signing Method	Best Use Case
In-Studio Kiosk	Clients sign on a tablet during check-in
Mobile Phone	Clients sign via a link sent via text or email
Website Embed	Forms displayed directly on your booking page

This form is used by wellness spas and oxygen therapy providers to ensure clients are informed about the session process, including common physical effects like pressure changes in the ears or sinuses. It helps staff manage client expectations during the service by confirming that participants understand the specific nature of hyperbaric treatments before they begin their session.

Participant personal contact information
Verification of known health contraindications
Acknowledgment of expected pressure sensations
Standard post-session care instructions
Sign-off for data privacy and record keeping

Questions about this waiver

What specific health risks or sensations should I include in the Hyperbaric Oxygen Consent Form?: You should include sections for clients to acknowledge common physical effects like ear pressure changes, potential sinus congestion, and the necessity of reporting any claustrophobic feelings during the session.
Can I add a field to this form that tracks if a client has undergone recent surgery or has specific medical hardware?: Yes, you can easily add custom text blocks or checklist fields to your Hyperbaric Oxygen Consent Form to verify the absence of contraindications like recent ear surgery or implants that might be sensitive to pressure.
What is the best way to present this consent form to clients right before they enter the oxygen chamber?: The most efficient method is to set up a tablet in your lobby or waiting area in kiosk mode, allowing clients to read and sign the form digitally immediately before their appointment.
Can I attach specific aftercare instructions to this consent form for clients to review after the session?: Absolutely, you can append a page to your form that details post-session care, such as hydration or monitoring for temporary vision changes, and require a secondary signature acknowledging those care steps.
How can I automatically organize these signed forms once a client completes the process?: All submissions are stored in your dashboard where you can filter them by date, client name, or service type, allowing you to quickly pull up a signed form if you need to double-check a client's acknowledgment of your safety protocols.

This template is framed for US and provided as a software tool, not legal advice. Waiver enforceability varies by jurisdiction and circumstance — confirm the final wording with your own counsel before relying on it.