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Questionnaire & Agreement Form

The Questionnaire/Agreement is required to be completed only once per individual visiting Spa Escape and will remain valid for all future visits by the same person.

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If any information relevant to this form changes on subsequent visits, it is the responsibility of the undersigned to notify the staff and complete a new agreement form.

Spa Escape

Questionnaire & Agreement

Please fill out the following form.

Date of birth
Day
Month
Year

SESSION QUESTIONS

Session
Finnish Sauna
Russian Sauna
Unsure, surprise me
Part of a Group Booking, see Primary Contact Person.

Each style offers a unique experience—your ideal choice depends on the atmosphere you desire.


For Dry Finnish Saunas: Perfect for those who enjoy high temperatures (80–110°C) and minimal humidity, delivering the classic dry heat that defines a traditional Finnish sauna.


For Russian Saunas (Banya): Designed to accommodate frequent water splashes, this style promotes moderate temperatures (60–90°C) combined with elevated humidity levels (25–70%), creating a steamy, relaxing ambiance.

Experience?
Beginner - Not Experienced
Regular User - Experienced
Seasoned Experienced - I have a particular heat request
Aromatherapy

Aromatherapy in a sauna, is a relaxing experience that uses essential oils and herbs to improve mood and health. The heat and humidity of the sauna open pores, allowing the oils to penetrate the body. 


Depending on the aromas of the oils, herbs, flowers and plants used, you can achieve a variety of results, from full calmness and relaxation to invigoration and rejuvenation.


Complements to your experience you can enjoy one of our beautiful Rento Sauna scents or purchase your own Banya Broom.

MEDICAL

Saunas are generally safe for most users, however the following listed conditions are considered contraindications for the sauna use. Please indicate if any of the following apply to you.

Do you have high/low blood pressure?
No
Yes
Do you have circulatory problems?
No
Yes
Do you have a pacemaker or defibrillator?
No
Yes
Do you suffer from congestive heart failure?
No
Yes

Individuals with cardiovascular conditions or problems (hypertensions / hypotension), congestive heart failure, impaired coronary circulation or those who are taking medications which might affect blood pressure should exercise caution when exposed to prolonged heat. Heat stress increases cardiac output and blood flow in and effort to transfer internal body heat to the outside environment via the skin and respiratory system. This takes place primarily due to major changes/increases in the heart

Are you presently intoxicated due to consumption of drugs or alcohol?
No
Yes

Sauna and Alcohol / Alcohol abuse - Alcohol intoxication decreases a person’s judgement; therefore he/she may not realize when the body has a negative heat reaction to high heat. Alcohol also increases the heart rate, which may be further increased by heat stress. The staff of the Spa Escape maintains the right to deny entry to anyone who is obviously exceedingly under the influence of alcohol or cannabis or ask them to leave.

Do you suffer from Parkinson's or Multiple Sclerosis?
No
Yes
Do you suffer from central nervous system donor or diabetic neuropathy?
No
Yes
Are you pregnant? Pregnant women should consult a physician before using a sauna.
No
Yes
Yes, I have consulted with my doctor.
Do you have a fever?
No
Yes
Have you had a recent joint or tissue injury or inflammation that is still hot or swollen?
No
Yes

Saunas and Joint injury - While some saunas (infrared) have supporting evidence that sauna use may be beneficial to joints, care for a recent injury (within 48 hours) to a joint should be under the advisement of a doctor. Heating a recent joint injury is not recommended.

Are you prone to bleeding or do you have recent wounds from an operation?
No
Yes

Saunas and Haemophiliacs / Individuals prone to bleeding - the use of sauna should be avoided by anyone who is predisposed to bleeding.

Are you currently taking diuretics, barbiturates, beta-blockers or antihistamines?
No
Yes
Are you under the age of 18? If yes you will need to provide parental permission.
No
Yes

This facility requires all clients to be 18 years old and over to enter, to be able to sign this agreement personally.

Are you over the age of 65?
No
Yes

The ability to maintain core body temperature may decrease with age. This is primarily due to circulatory conditions and decreased sweat gland function. The body must be able to activate its natural cooling process in order to maintain core body temperature.

Do you have metal pin, rod, artificial joint to other surgical implants?
No
Yes

Saunas and implants - If you have metal pins, rods, artificial joints or any other surgical implants, you should consult your physician prior to using a sauna.

Do you have a hard time breaking a sweat?
No
Yes

Sauna and Chronic Conditions / Diseases associated with reduced ability to sweat or perspire - Multiple Sclerosis, Central Nervous system tumours and diabetes with neuropathy and conditions that are associated with impaired sweating.


Sauna and Insensitivity to heat - an individual with insensitivity to heat should not use a sauna.

Other conditions or allergies including essential oils or trees?
No
Yes

(please supply additional information below)?

If you answered "yes" to any of the above questions, you should consult with your physician before using our sauna and spa or use extreme caution when using our sauna/spa. We strongly recommend to consult with your doctor if you condition would be negatively affected by sauna use. In the rare event that you experience pain and/or discomfort, dizziness, light-headedness, or disorientation, immediately discontinue sauna/spa use and inform our staff about your condition.

Water consumption is a requirement for using the sauna. All sauna users are required to drink water before, during and after a sauna sessions. Complimentary water is provided in the fridge for your convenience.

TERMS & CONDITIONS

I understand that the services offer by Spa Escape are for the

purpose of relaxation and overall wellness and are not intended to take the place of medical care or medications.


I have read the above disclaimer, I have had the opportunity to ask any questions about its content, and by signing I agree that I am currently not suffering from any of the contraindications in questionnaire. I agree to disclose to Spa Escape if my medical history changes during the period of participating in sauna/spa sessions.


It is solely my responsibility to monitor my body/reactions and determine if it is appropriate to use the sauna/spa. I alone am responsible for my safety and well being. If I experience pain, dizziness, or any discomfort during my sauna session, I am responsible for immediately stopping my

sauna/spa session.


I acknowledge that Spa Escape have areas of water and floors may be slippery therefore I am full responsible for any injuries related to slipping on the floor and other surfaces. I know that I am also responsible for all my personal items. I acknowledge that Spa Escape retains the right to deny entrance or remove anyone who is exceedingly under the influence of alcohol or cannabis.


I have read the above statement and I understand that the use of sauna/spa may involve a physical and/or mental risk. By signing below, I assume the risk and responsibility for any and all injuries and damages that arise from using the sauna/spa and hereby waive and release Spa Escape and its staff from any and all liability in connection with the use of the sauna/spa house. This agreement is valid for all future visits by the undersigned. If on subsequent visits anything has changed relevant to this agreement form, it is the responsible of the undersigned to inform the staff and sign a new agreement form.

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