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Red Light Therapy
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Red Light
To nominate us for all your prescription needs please complete the form below
Is Red Light Therapy suitable for me
Name:
Phone no:
Please only tick ONE answer per question
We will not treat you if you answer
YES
to any of the questions below.
Do you have recent burns?
No
Yes
Do you have malignant cancers?
No
Yes
Do you have skin cancer?
No
Yes
Do you have Hyperthyroidism (Neck and Upper Chest Only)?
No
Yes
Do you have epilepsy?
No
Yes
Do you have eye disease?
No
Yes
Light sensitivity?
No
Yes
Are you pregnant?
No
Yes
Do not use the Red Light Therapy without consulting your doctor if you are or have the following:
Fever or infection
No
Yes
Systemic Lupus Erythematosus (SLE)
No
Yes
Severe Bleeding or Blood Loss
No
Yes
Use of Photosensitizing Medications
No
Yes
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Date:
Therapist:
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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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Hyperbaric Health & Healing
1 Eldersley Close, Redhill, RH1 2AJ
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