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HBOT Medical declaration

Please answer the following questions on your past or present medical history with Yes or No  * If you are not sure, please answer Yes *
Could you be pregnant, or are you attempting to become pregnant?
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Have you ever had or do you currently have any of the following?
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Lung Cancer, pneumonia, pulmonary fibrosis
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Ears or Sinus disease/surgery ie Stapedectomy, congestion (difficulty on airplanes) 
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Recent (within the last 12 months) perforated ear drum
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Claustrophobia
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Diabetes, low blood sugar
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Heart Disease (Congestive Heart Failure) or Ejection Fraction less than 35%
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Do you have cataracts or any other eye disease
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Do you have any implanted medical devices (DBS, Pacemaker, etc)
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Are you presently taking prescription medications or medically being treated? If so, please specify below:
The information I have provided about my medical history is true and accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health conditions.
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HBOT and light-based therapies are complementary wellness therapies and are not intended to diagnose, treat, cure, or prevent disease.

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