Terms Of Business
WINGS HYPERBARICS will require a patient to sign the following document:
MULTIPLACE CHAMBER INDEMNITY, CONSENT & WAIVER FORM
PROCEDURE & TREATMENT DESCRIPTION
The Participant agrees to undergo hyperbaric oxygen therapy (HBOT) in a multiplace pressurised chamber. The procedure entails breathing high-concentration oxygen under pressure, as prescribed and supervised by the designated hyperbaric medical practitioner.
RISK ACKNOWLEDGEMENT
The Participant acknowledges and understands that HBOT, like all medical procedures, may entail risks and complications, including but not limited to:
-
Ear and sinus barotrauma.
-
Breathing difficulties, pneumothorax
-
Oxygen toxicity, seizures, vision changes
-
Sinus or dental pain, claustrophobia, temporary visual disturbance
-
Fire, equipment malfunction
-
Deterioration due to pre-existing conditions
-
Unanticipated adverse reactions or emergencies
MEDICAL DISCLOSURE
The Participant confirms that all medical information provided is true and complete, and undertakes to disclose any changes in health, medications, diagnoses, or allergies prior to every HBOT session.
VOLUNTARY CONSENT
The Participant confirms understanding of the procedure, alternative treatments, potential complications, and voluntarily consents to HBOT as outlined, with opportunity given for questions and answers.
INDEMNITY & LIMITATION OF LIABILITY
The Participant, by signature below, waives any and all claims against Wings Hyperbarics, associated partners, directors, employees, affiliates, agents, contractors, and medical staff (“the Indemnitees”) for damages, losses, or injuries, including death, arising from participation in HBOT, save for damages directly caused by proven gross negligence or intentional misconduct by the Indemnitees.
The waiver applies to all South African and international claims, and is binding on the Participant’s heirs, dependants, successors, and assigns.
The Participant indemnifies and holds harmless all Indemnitees from any claims or legal actions initiated by third parties as a result of the Participant’s participation.
EMERGENCY INTERVENTION & MEDICAL RECORDS
The Facility is authorised to provide emergency medical care, administer first aid, or arrange ambulance/hospital transfer should the need arise.
The Participant agrees to the sharing or requesting of medical records with relevant practitioners for safe care. The Facility abides by POPIA and relevant international data laws in managing personal health information.
INSURANCE, FINANCIAL RESPONSIBILITY & TRAVELERS
The Participant acknowledges financial responsibility for all costs not covered by medical aid, insurance, or travel insurance, including additional care, hospitalisation, or repatriation if required.
International Participants understand and accept the benefits and limitations of their coverage while in South Africa.
INFORMED ACCEPTANCE
The Participant acknowledges:
-
This indemnity does not limit statutory rights in terms of South African CPA (Consumer Protection Act), or exclude liability for criminal intent/gross malpractice.
-
This agreement, including waiver and indemnity, is governed by the laws of South Africa; international Participants agree to jurisdiction within the Republic of South Africa for all legal proceedings.
SIGNATURE & DECLARATION
By signing below, the Participant confirms that they:
-
Have read this form (or have had it read and explained)
-
Understand and accept all terms, risks, and obligations
-
Consent freely to participate in HBOT, subject to medical assessment
-
Agree to the release, indemnity, and waivers as stated herein
