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First Experience
Consent & Safety Acknowledgment

We're looking forward to welcoming you to Imagine Health.

Your first experience may include body composition analysis, red and near-infrared light therapy, whole-body vibration and a personal consultation.

Please take a moment to review the following information so that we can provide you with a comfortable and appropriate experience.

Participation in each component is voluntary. You may ask questions or choose not to participate in any component at any time.

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Your Information

01

InBody Body Composition Analysis

Your Imagine Health experience may include an InBody body composition assessment.

The InBody uses Bioelectrical Impedance Analysis (BIA), which passes a low-level electrical current through the body to estimate measurements such as body fat, muscle mass and other body composition metrics.

The test is quick and non-invasive.

Do you have a pacemaker, implanted electronic medical device, or other essential electronic medical support device?

Do you have a pacemaker, implanted electronic medical device, or other essential electronic medical support device?

Are you currently pregnant or is there a possibility you may be pregnant?

Are you currently pregnant or is there a possibility you may be pregnant?

02

Red & Near-Infrared Light Therapy

Your experience may include exposure to red and near-infrared light using specialized light-emitting equipment.

Red and near-infrared light therapy is commonly incorporated into wellness and recovery routines. Individual responses and experiences vary.

During your session you may experience bright light and mild warmth from the equipment.

You should notify Imagine Health staff immediately if you experience unusual discomfort, dizziness, lightheadedness, nausea, visual discomfort, excessive warmth or otherwise feel unwell.

Do you have a known sensitivity to bright light or a condition associated with photosensitivity?

Do you have a known sensitivity to bright light or a condition associated with photosensitivity?

Are you currently taking any prescription medication, over-the-counter medication or supplement that you have been advised may increase sensitivity to light?

Are you currently taking any prescription medication, over-the-counter medication or supplement that you have been advised may increase sensitivity to light?

Are you currently undergoing medical treatment or have you been advised by a healthcare provider to avoid light-based treatments?

Are you currently undergoing medical treatment or have you been advised by a healthcare provider to avoid light-based treatments?

Protective eyewear is available.

If you experience light sensitivity or would prefer protective eyewear during your session, please let Imagine Health staff know before your session begins.

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Whole-Body Vibration

Your first experience may include approximately 10 minutes of low-intensity whole-body vibration while standing on a vibration platform.

Whole-body vibration may not be appropriate for everyone.

Do any of the following currently apply to you?

Do any of the following currently apply to you?

Select all that apply.

If at any point during the vibration session you feel dizzy, lightheaded, nauseated, unstable, experience pain or otherwise feel unwell, stop immediately and notify Imagine Health staff.

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General Safety Acknowledgment

  • I understand that I am responsible for informing Imagine Health of relevant health conditions, medications, injuries, pregnancy, implanted medical devices or other circumstances that could affect my participation.
  • I understand that I should notify Imagine Health if my health status or medications change.
  • I understand that I may ask questions before participating in any component of my experience.
  • I understand that participation is voluntary and that I may decline or stop any portion of the experience at any time.
  • I agree to follow reasonable safety instructions provided by Imagine Health staff.
05

Results & Expectations

  • I understand that individual responses to wellness, recovery and body composition services vary.
  • Imagine Health does not guarantee weight loss, fat loss, inches lost, changes in body composition, pain reduction, improved athletic performance, improved health or any other specific result.
  • I understand that services provided by Imagine Health are intended for general wellness, fitness, recovery and performance purposes and are not a substitute for medical diagnosis, medical treatment or care from a qualified healthcare provider.
  • I understand that information provided by Imagine Health should not be interpreted as medical advice.
06

Informed Consent & Assumption of Risk

  • I acknowledge that I have had the opportunity to review the information above and ask questions before participating.
  • I understand that participation in wellness, body composition, red light therapy and whole-body vibration activities may involve risks, discomforts or adverse reactions that cannot always be predicted or eliminated.
  • I voluntarily choose to participate in the Imagine Health services for which I am eligible and agree to immediately notify staff and discontinue participation if I experience concerning symptoms or discomfort.
  • I understand and voluntarily assume the inherent and reasonably foreseeable risks associated with my participation.
07

Release of Liability

  • To the extent permitted by applicable law, I release Imagine Health and its owners, employees, agents and representatives from claims arising from the ordinary inherent risks of my voluntary participation in Imagine Health services.
  • This release does not apply where such a release is prohibited by law.
  • I understand that this release is intended to be read together with the informed consent and assumption of risk section above.
08

Client Acknowledgment

Sign below. If drawing isn't convenient, your typed full name below serves as your electronic signature.

Sign above using your finger, stylus or mouse.

By submitting this form you agree that your electronic signature has the same effect as a handwritten signature. The date and time of your submission, and the exact version of this consent language, are recorded with your signature.

Your responses are stored securely and reviewed only by Imagine Health staff.