Waiver And Consent

Thank you for choosing Premiere Recovery Lab as your exercise recovery solution. We firmly believe that advanced recovery techniques should be accessible for individuals seeking to benefit from improved performance, health and pain reduction. Our San Jose recovery center is offering the most advanced techniques once reserved for just professional athletes. We hope that you’ll enjoy our therapies.

Please note that usage of our services are governed by the below “Waiver And Consent” form.

  1. In consideration for using the CRYOSENSE© (the “Equipment”), I hereby EXPRESSLY RELEASE, WAIVE, DISCHARGE, AND HOLD HARMLESS: PREMIERE RECOVERY LAB, ITS MEMBERS, OWNERS, OFFICERS, REPRESENTATIVES, AGENTS, EMPLOYEES, CONTRACTORS, ASSIGNEES AND VOLUNTEERS (HEREINAFTER REFERRED TO AS THE “RELEASES”), FROM ANY AND ALL CLAIMS (INCLUDING, BUT NOT LIMITED TO, CLAIMS FOR PROPERTY DAMAGE, PERSONAL INJURY OR DEATH), LIABILITY, DEMANDS, ACTIONS AND CAUSES OF ACTION WHATSOEVER, WHETHER FORESEEABLE OR NOT, FOR NEGLIGENCE, CARELESSNESS, AND STRICT LIABILITY OR OTHERWISE (INCLUDING, BUT NOT LIMITED TO, ANY NEGLIGENCE OF THE RELEASEES), ARISING OUT OF OR RELATED TO ANY LOSS, DAMAGE OR INJURY THAT MAY BE SUSTAINED BY ANY PERSON, WHILE USING THE EQUIPMENT OR DUE TO THE USE OF THE EQUIPMENT.
  2. I hereby confirm and agree that THE RELEASEES HAVE NOT MADE AND DO NOT HEREBY MAKE, NOR SHALL THIS WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT (THIS “AGREEMENT”) NOR THE CRYO PROCESS TO BE PERFORMED BY THE RELEASEES UNDER THIS AGREEMENT GIVE RISE TO ANY REPRESENTATION, WARRANTIES OR COVENANTS (EXPRESS, IMPLIED, ORAL OR OTHERWISE), INCLUDING WITHOUT LIMITATION, ANY IMPLIED WARRANTY OF MERCHANTABILITY, WORKMANSHIP OR FITNESS FOR A PARTICULAR PURPOSE, WITH RESPECT TO THE CRYO PROCESSES. I UNEQUIVOCALLY REPRESENT, ACKNOWLEDGE AND STATE THAT IN EXECUTING AND DELIVERING THIS AGREEMENT, I AM NOT RELYING UPON ANY WARRANTIES, REPRESENTATIONS, PROMISES OR STATEMENTS, WHETHER EXPRESS OR IMPLIED, MADE BY of the process, including possible adverse reactions, side effects or other possible complications. It is understood that this Agreement I being given in advance of any administrative process and is being given by me voluntarily to use the Equipment.
  3. I am fully aware of the risks and hazards connected with the use of the Equipment, including participating in said Equipment usage, and entering the above named premise to engage in such usage. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY that may be sustained as a result of being engaged in such an activity.
  4. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM AND AGAINST ALL RISK AND CLAIMS OF ANY NATURE FOR ANY LOSS, LIABILITY, DAMAGE OR COSTS THAT I MAY INCUR DUE TO THE USE OF EQUIPMENT BY ME, SPECIFICALLY INCLUDING, BUT NOT LIMITED TO, NEGLIGENT ACTS BY MYSELF OR OTHERS.
  5. It is my express intent that this agreement shall bind the members of my family and my spouse (if any), if I am alive and my heirs, assignees and personal representatives if I am not alive, and shall be deemed as a RELEASE, WAIVER AND DISCHARGE of the above named RELEASEES. I hereby further agree that this Agreement shall be construed in accordance with the laws of the State of CALIFORNIA.
  6. I understand that the RELEASEES will not be responsible for any medical costs associate with any injury.
  7. I understand that the services provided are for the basic purposes of relaxation, stress reduction, relief of muscular tension, recovery from muscular tension and recovery from surgery, illness or injury. I further understand that these services should not be construed as a substitute for medical examination, diagnosis of treatment and that I should see a physician, chiropractor or other qualified medical specialist for any mental or physical ailment that I am aware of.
  8. I understand that the therapists are not qualified to perform skeletal adjustments, diagnose and/or prescribe and that nothing said in the course of the session should be construed as such.
  9. Because CRYOSENSE© Cryotherapy is contraindicated under certain conditions, I affirm that I have read the Informed Consent Form and my known medical conditions do not fit any of the contraindications. I agree to keep the therapist updated as to any changes in my medical profile and understand that there shall be no liability on the therapist’s part should I forget to do so.

My electronic signature constitutes my acknowledgment that (1) I have carefully read this entire Agreement and fully understand and agree to be bound by its contents, (2) the proposed cryotherapy process has been satisfactorily explained to me and I have all of the information I desire, and (3) I hereby give my authorization and consent. The Agreement shall stand as long as I use the equipment at the location now and in the future.

I have read the instructions for proper use of the facilities and do so at my own risk and hereby release the RELEASEES, owners, operators, franchisers, or manufacturers, from any damage or harm that I may incur due to use of the facilities.

IN SIGNING THE AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I HAVE GIVEN UP CONSIDERABLE FUTURE LEGAL RIGHTS; AND I EXECUTE THIS AGREEMENT FREELY, VOLUNTARILY, UNDER NO DURESS OR THREAT OF DURESS, WITHOUT INDUCEMENT, PROMISE OR GUARANTEE BEING COMMUNICATED TO ME.

Furthermore, I agree that I will comply with all instructions on the use of the Equipment and that I am using these services at my own risk. I agree to use all sessions within the terms of the contract dates and understand that refunds are not given on unused portions of purchased packages.

INFORMED CONSENT FORM

Safety and use standards during Cryosense thermal cryo-contrast session:

  1. It is necessary to expose the skin to the cold during the entire session.
  2. It is required to wear underwear.
  3. Wearing socks is allowed as long as they are completely dry, not even slightly humid.
  4. The use of creams before a session is prohibited. It is necessary to remove them completely.
  5. The use of rings, necklaces and piercings, watches and bracelets is prohibited.
  6. After the elevator stops, put your hands on the top edge of the cabin or crossed on your chest. The use of gloves is allowed during the session, as long as they are dry.
  7. You must move (rotate) gradually in the cabin during the session.
  8. Nitrogen is not toxic (it represents 78% of the air we breathe), however, it should not be breathed.
  9. The session may end at any time. You can open the door voluntarily or ask to stop the session to the person who will always be present during your session.

Contraindications of the whole body thermo-contrast therapy:

  • Severe general condition of the patient.
  • Fever (above 37.5°C, or 99.5°F).
  • Decompensation of chronic cardiovascular diseases.
  • Acute myocardial heart attacks and rehabilitation period after the heart attack.
  • Heart failure stage II.
  • Unfavorable prognosis heart rate and conduction disorders.
  • Essential hypertension stage II or III (AP>180/100 mmm of mercury).
  • Stroke
  • Raynaud’s syndrome acrocyanosis, systemic vasculitis.
  • Cryoglobulinemia, agammaglobulinemia, cryofibrinogenemia.
  • Active pulmonary tuberculosis.
  • Malignant tumors.
  • Hemorrhagic diathesis.
  • Hysterical Neurosis.
  • Person’s intolerance to the cold.
  • Cold urticarial.
  • Pregnancy.
  • Children under 14 prior parent consent.

I have read the safety standards and contraindications listed above, and confirm the full knowledge of safety standards and none of the contraindications shown.