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Immersive Chakra Healing Experience with Infrared Heat (Sauna)

Sauna Client Waiver

First name

Last name

Phone

Birthday

Day

Month

Year

Have you consulted a healthcare professional regarding sauna use?

Yes

N/A

Do you feel well enough today to participate in a sauna session?

Yes

Please read and initial each statement:

I understand that sauna use involves exposure to elevated heat, which may cause dehydration, dizziness, or other physical reactions.

I confirm that I will remain hydrated before, during, and after my sauna session.

I agree to follow all safety guidelines and staff instructions while using the sauna.

I have read and agree to the Suana Terms and Condition (https://www.sallyheinjus.com/heattermsandconditions)

I acknowledge that these sessions may involve deep rest, emotional release, or subtle physical sensations from sound vibrations and energetic work. This is normal and part of the healing experience.

Which Chakra do you wish to focus on today

Root Chakra (Muladhara): Located at the base of the spine, it is associated with a sense of security and survival. Colour RED

Sacral Chakra (Svadhisthana): Situated in the lower abdomen, it governs emotions and creativity. Colour ORANGE

Solar Plexus Chakra (Manipura): Found in the upper abdomen, this chakra relates to personal power and confidence. Colour YELLOW

Heart Chakra (Anahata): Located in the center of the chest, it is associated with love, compassion, and emotional healing. Colour GREEN

Throat Chakra (Vishuddha): Centered in the throat, it is linked to communication and self-expression. Colour: Blue

Third Eye Chakra (Ajna): Positioned between the eyebrows, it corresponds to intuition and wisdom. Colour INDIGO

Crown Chakra (Sahasrara): Found at the top of the head, this chakra connects to spirituality and higher consciousness. Colour VIOLET

Unsure

Any music requests? (favourite artist or genre)

By signing below, I acknowledge and agree that:

I have voluntarily chosen to participate in sauna services provided by Sally Heinjus.

I have read, understood, and agree to the Terms and Conditions provided by Sally Heinjus. https://www.sallyheinjus.com/heattermsandconditions

I accept full responsibility for my own health, safety, and wellbeing during and after sauna use.

I release and discharge Sally Heinjus from any liability, claims, demands, or causes of action arising from my participation, except where prohibited by law.

I understand that it is my responsibility to inform Sally Heinjus if I experience any new or unusual symptoms during the course of my sessions.

I confirm that all information provided on this form is true and complete to the best of my knowledge.

Signature

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