EXOPOD TREATMENT — INFORMED CONSENT & RELEASE FORM

1. INTRODUCTION

The ExoPod is a non-invasive wellness pod that combines multiple technologies to support wellness, body contouring, recovery, and relaxation. The session may include:

• Advanced Thermal Technology (heat-based fat metabolism support)
  
• Muscle Stimulation (EMS)
  
• Infrared Heat
  
• Himalayan Salt Therapy
  
• BioAlign Magnetic Field Therapy
  
• Oxygen & Negative Ion Therapy
  
• DeepWave Energy Therapy
  
• PhotonGlow Red/NIR Light Therapy
  
• Ambient Relaxation Light Therapy
  
• Vibration Pulse Therapy
  
• Ozone-Based Disinfection (between clients)
  

This treatment is not a medical procedure, not a substitute for medical care, and results may vary.

2. PURPOSE OF THE TREATMENT

Clients may use the ExoPod to support:

• Weight management & fat reduction support
  
• Muscle recovery & pain relief
  
• Improved circulation & detox support
  
• Lymphatic flow and reduced swelling
  
• Skin tightening & anti-aging support
  
• Relaxation, stress reduction, improved mood
  
• Overall wellness and vitality
  

I understand that none of these benefits are guaranteed, and this treatment does not diagnose, treat, or cure any medical condition.

3. CONTRAINDICATIONS — I CONFIRM THAT NONE OF THESE APPLY (OR I HAVE DISCLOSED THEM)

I agree to inform AI Wellness staff if any of the following apply:

Absolute Contraindications:

• Pacemaker or implanted electronic device
  
• Pregnancy or breastfeeding
  
• Active cancer or undergoing chemotherapy/radiation
  
• Uncontrolled hypertension
  
• Severe cardiovascular disease
  
• Epilepsy or seizure disorders
  
• Open wounds, infections, or active skin conditions
  
• Recent surgery (within past 6–12 weeks unless cleared by physician)
  
• Fever, illness, or active viral/bacterial infection
  

Relative Contraindications (require physician clearance):

• Diabetes with neuropathy
  
• Metal implants in treatment areas
  
• Autoimmune disorders
  
• Chronic inflammatory disease
  
• Respiratory disorders such as COPD or severe asthma
  
• Heat intolerance or history of heat stroke
  
• Severe varicose veins
  
• Hormonal disorders impacting thermoregulation
  

I agree that I will disclose all medical conditions prior to treatment.

4. POTENTIAL RISKS & SIDE EFFECTS

I understand that, while uncommon, possible side effects include:

• Temporary redness or skin warmth
  
• Mild muscle soreness
  
• Temporary fatigue
  
• Increased sweating
  
• Lightheadedness if dehydrated
  
• Flu-like detox symptoms
  
• Temporary swelling
  
• Allergic response to heat or materials (rare)
  
• Discomfort related to EMS or vibration
  
• Aggravation of pre-existing conditions if undisclosed
  

Heat-based therapies can elevate heart rate and blood pressure.

I confirm I am healthy enough to undergo heat, EMS, vibration, and light-based treatments.

5. TREATMENT EXPECTATIONS

I understand and agree:

• This treatment is wellness-oriented, not a medical treatment.
  
• Results vary and depend on hydration, lifestyle, diet, and consistency.
  
• No guarantee of fat loss, weight loss, or aesthetic improvement is being made.
  
• Multiple sessions may be required for best results.
  
• I must follow post-care guidelines (hydration, rest, etc.).

By signing this consent form, I confirm and acknowledge all the above.

7. LIABILITY RELEASE

I understand and agree:

• AI Wellness Center of Excellence, its owners, staff, and affiliates are not liable for any injury or reaction resulting from undisclosed medical conditions or failure to follow instructions.
  
• I voluntarily assume all risks.
  
• This treatment is not covered by insurance.
  
• I release AI Wellness Center of Excellence from liability for:
  – temporary side effects
  – lack of expected results
  – my own failure to disclose relevant medical conditions
  – aggravation of conditions not disclosed
  

I certify that all information I have provided is accurate.

8. CONSENT TO TREAT

I authorize AI Wellness Center of Excellence to perform ExoPod wellness treatments.

I understand this is a voluntary, elective, non-medical service.

9. CLIENT RESPONSIBILITY DURING SESSION

I agree to:

• Stay hydrated before/after the session
  
• Notify staff immediately if I feel dizzy, overheated, or unwell
  
• Avoid alcohol before treatment
  
• Avoid large meals within 1 hour
  
• Follow safety and post-care instructions

10. ACKNOWLEDGMENT OF NO MEDICAL CLAIMS

I understand and agree that:

• ExoPod treatments do not diagnose, treat, or cure disease.
  
• AI Wellness staff do not provide medical advice.
  
• I will consult my physician for any medical concerns.
  

11. HIPAA & PRIVACY

AI Wellness protects your private health information in compliance with HIPAA guidelines.

Your data will be stored securely in:

AI Wellness Connect App, Digital Twin Dashboard, and EMR/EHR (DrChrono).

12. CANCELLATION POLICY

I understand that missed appointments or cancellations within 24 hours may incur a fee.

13. PAYMENT & MEMBERSHIP DISCLOSURE

I understand:

• ExoPod sessions may be part of memberships, packages, raffles, or promotional offerings.
  
• All sales are final; no refunds for completed sessions.