HOCATTTM Assessment/Registration Form

Date of Birth(Required)

Home address

Contact Details

There are certain conditions where certain modalities should not be used. Please answer the questions below.

Do you or have you ever had- Yes/No
Recent fever(Required)
Heat insensitivity(Required)
Low blood sugar levels(Required)
Uncontrolled high blood pressure (BP)(Required)
Low blood pressure(Required)
Taking BP medication(Required)
Active bleeding (injury)(Required)
Bleeding tendencies e.g. haemophiliacs/ Von Willebrands etc(Required)
Known heart conditions e.g. heart failure, recent MI, arrhythmias etc.(Required)
Blood clots e.g. DVT/PE/CVA(Required)
Surgery in last 72 hours(Required)
Broken, injured, swollen, inflamed or infected skin on hands or feet(Required)
Cancerous or malignant tissue(Required)
Epilepsy or seizures(Required)
Electrical implant e.g. pacemaker, cochlear implants, insulin pump, or any internal device that works with batteries (electrical energy)(Required)
Implanted metals e.g. pins, plates, screws, joint replacement, mechanical heart valves, metal stents etc.(Required)
G6PD deficiency(Required)
Cutaneous porphyria(Required)
Are there any other medical conditions your practitioner should be aware of? YES/NO(Required)

Please Note:

It is very important to drink plenty of water before and after a HOCATTTM session, as well as throughout the rest of the day. Drinking water helps your body to flush out toxins. Detoxifying the body too fast can overload the bodies’ avenues of elimination. Overloading can result in a detox reaction or “cleaning crisis”. You could experience anything from flu-like symptoms to a skin rash. This is why at IV Boutique we start low, slow, and build up each session and why you should drink plenty of water! Thank you for completing the Registration form, one of our Registered Nurses will be in touch to talk you through the amazing benefits, the process and make a booking if you haven’t already!
This field is for validation purposes and should be left unchanged.