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Whole Body Vibration Consent

Whole Body Vibration ConsentKyle Gordon2022-05-30T19:33:55-06:00

Whole Body Vibration Consent

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Patient Information

Patient Name*

Whole Body Vibration Consent

Please be advised that the K-1 platinum Whole Body Vibration Machine is being used for the purpose of exercise and other health benefits. Read and follow all instructions and warnings and obtain proper instruction prior to using the K1 Machine. if you have any of the conditions listed below, please consult a physician before using. This device may not be suitable for everyone. Strong vibration affecting the neck and head can occur when using positions other than standing. Consulting a physician for approval is recommended. Misuse of this machine could result in serious injury. Keep children under age 12 away from this machine. User weight must not exceed 325 pounds. Stop exercising if you feel pain, faint, dizzy, or short of breath.
If you have have of the following diagnosed conditions, please place a check mark and discuss with your Doctor:*
Consent
I understand that I may be able to use the K-1 Whole Body Vibration Device even though I have check marked any of the above conditions. I further understand that I use the K-1 Whole Body Vibration Device at my own risk.

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This field is for validation purposes and should be left unchanged.

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