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Is this your first time doing hyperbarics?

To the best of your ability, do you believe you will be able to run the chamber by yourselfAre You Able To Run The Session By Yourself?

Would you like Legendary O2 staff to come supervise additional sessions?

How did you hear about Legendary O2 (Physician, Client Referral, Online, Social Media, Word of Mouth, Advertisement)?

List the name of your referring physician or client referral

Please note that our Share The Love Referral Program gives clients $$$ towards their next package for referring new clients. Don't forget to ask us about our Share The Love Program, and see how you can get credit towards your next rental! Put N/A if not applicable.

List any allergies (especially to medications or materials that may come into contact with the chamber)

List any recreational or prescription drugs that may affect your ability to self-operate the chamber.

All persons must fully disclose all and any intended purposes for usage and health barriers that could be part of our contraindication list that prohibit usage of any Legendary O2 equipment, including any recreational or prescription drugs that would inhibit you from operating the chamber. Put N/A if not applicable.

List your primary health concerns or pre- exhistingconditions

Medical Disclaimer

The information and services provided by Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting, including but not limited to hyperbaric oxygen therapy (HBOT), are not intended to diagnose, treat, cure, or prevent any medical condition. HBOT is a complementary therapy, and its benefits may vary from person to person. All sessions and rental packages are provided based on informed consent and the understanding that results are not guaranteed.

Limitation of Liability

Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting, its affiliates, staff, and representatives shall not be held liable for any injuries, adverse effects, or other complications that may arise from the use of hyperbaric oxygen therapy or related services. Clients acknowledge that they are participating in therapy voluntarily and assume all associated risks. The Client acknowledges the use of the equipment is inherently dangerous ff certain safety protocols are not followed. Violation of any of the prohibited behaviors listed in this Agreement will result in immediate contract termination, additional liability for damages, and forfeiture of the damage waiver.

Medical and Mental Health Certification

I certify that I am in good mental and physical health, and have no contagious conditions that may affect the safety or well-being of myself, The Company, its staff,and its affiliates or others. I certify that I have disclosed all relevant medical conditions, and I understand that I am responsible for seeking additional clearance from my healthcare provider if needed. By signing below, I certify that I have read, fully understand, and voluntarily agree to the terms outlined in this consent form. I acknowledge that I have been given the opportunity to ask any questions regarding the therapy, risks, and benefits and that all my questions have been answered to my satisfaction.

Accuracy of Information

I certify that the information I have provided is complete, accurate, and truthful to the best of my knowledge. I understand that any omission or falsification of information may result in serious health risks, complications, or disqualification from receiving sessions or a chamber rental package. I agree to notify Legendary O2: Hyperbaric Chamber Rentals & O2 Wellness Consulting immediately of any changes in my health condition or medications that may affect my eligibility for treatment.

Privacy Policy

This Privacy Policy (“Policy”) governs the collection, use, storage, and protection of your personal and health information when you interact with the services, website, or customer portal provided by Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting (“Company,” “we,” “our,” or “Legendary O2”). By accessing and using our services, you (“The Client” or “Your”) agree to comply with and be bound by this Privacy Policy. Please read it carefully. (1.) HIPAA Compliance & Patient Privacy Protection Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting is committed to maintaining the privacy and security of your personal health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and all applicable privacy laws. (i.) How Legendary O2 Protects Your Health Information: Legendary O2 implements strict safeguards to protect your health information, which includes: (a) Confidentiality: Your personal and medical information is kept strictly confidential and accessible only to authorized personnel, (b) Secure Data Storage: Legendary O2 uses industry-standard encryption and security protocols to protect electronic records, (c) Limited Access: Only necessary Legendary O2 team members have access to your health data to provide you with services, (d) No Unauthorized Sharing: Legendary O2 does not sell, share, or distribute your information to third parties without your explicit consent, except as required by law, (e) Compliance with Federal & State Laws: Legendary O2's privacy policies align with HIPAA regulations to ensure your rights to privacy and security are upheld. (ii.) Your Rights Under HIPAA: You have the following rights under HIPAA: (a) You have the right to access and request a copy of your health records, (b) You can request corrections to any inaccuracies in your information, (c) You have the right to know how your information is used and disclosed, (d) You can restrict certain uses or disclosures of your health data, (e) You have the right to file a complaint if you believe your privacy rights have been violated. (iii.) How We Use Your Health Information: Legendary O2 collects and stores your medical history and health details only for the purpose of providing Hyperbaric Oxygen Therapy services and ensuring your safety. This information may be used for: (a) Conducting safety screenings and eligibility assessments, (b) Customizing your chamber rental plan based on your health needs, (c) Communicating with you about your package, sessions, progress, or scheduling, (d) Fulfilling legal or regulatory compliance requirements. (iv.) How to Contact Legendary O2 About Privacy Concerns: If you have any questions about our privacy practices or wish to exercise your rights under HIPAA, please contact our Privacy Officer at info@Legendaryo2.com with the subject line “HIPAA”. (2.) Information Legendary O2 may collect the following types of information: from The Client (i.) Personal Information: (a) Name, address, phone number, and email address, (b) Date of birth and emergency contact information, (c) Payment and billing details. (ii.) Health Information: (a) Medical history, conditions, or contraindications related to Hyperbaric Oxygen Therapy (HBOT), (b) Health screenings, consent forms, and treatment records, (c) Any additional health disclosures required for safe sessions. (iii.) Technical & Usage Information: (a) IP address, device type, and browser information, (b) Website activity, such as pages visited and time spent on the site, (c) Cookies and tracking technologies (where applicable). (3.) How Legendary O2 Protects Your Information We implement strict security measures to protect your data, including: (i.) HIPAA Compliance: Legendary O2 follows all HIPAA regulations to ensure your health information is secure, (ii.) Encryption & Secure Storage: Legendary O2 uses industry-standard encryption and secure servers to protect personal and medical data, (iii.) Access Restrictions: Only authorized personnel at Legendary O2 can access sensitive client information, (iv.) Data Retention Policies: Legendary O2 retains records only for as long as necessary to provide services or comply with legal obligations, (v.) Security Monitoring: Legendary O2 regularly reviews and updates security protocols to prevent unauthorized access. (4.) Data Breach Notification Policy In the event of a data breach that compromises personal or health information, Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting will comply with applicable federal and state laws regarding data breach notifications. Affected individuals will be notified as required by law; however, Legendary O2 shall not be held liable for any damages resulting from third-party security breaches or cyberattacks beyond Legendary O2's control. (5.) Third-Party Service Provider Responsibility Legendary O2 utilizes third-party vendors to process transactions, store information, and provide operational support. While Legendary O2 requires these vendors to adhere to security and privacy standards, Legendary O2 is not responsible for security failures or breaches occurring within third-party systems or platforms beyond Legendary O2's direct control. (6.) Data Retention & Deletion Policy (i.) Retention: Legendary O2 retains personal and health data only as long as necessary to fulfill the purpose for which it was collected, comply with legal obligations, and resolve disputes. (ii.) Deletion: Upon request, and where legally permissible, personal data may be deleted. However, some records may be retained as required by law, regulatory agencies, or for tax and auditing purposes. (7.) No Warranty Disclaimer All information provided on our website, including health-related content, is for general informational purposes only. While Legendary O2 strives for accuracy, Legendary O2 makes no warranties, express or implied, regarding the accuracy, reliability, or completeness of the information provided. Users should consult a qualified healthcare professional for specific medical advice. (8.) International Data Transfer Policy Legendary O2 is based in the United States, and all data collected is stored and processed under U.S. law. If The Client accesses our services from outside the U.S., The Client acknowledges and agrees that The Client's data may be transferred, stored, and processed in the United States, where data protection laws may differ from those in The Client's international country. (9.) Updates to This Privacy Policy We may update this Privacy Policy from time to time. Changes will be posted on this page with the updated Effective Date. Your continued use of our services constitutes acceptance of any modifications. (10.) Contact Us If you have any questions about this Privacy Policy or how your information is handled, please contact us at: Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting Email: Info@LegendaryO2.com Phone: 818-966-4281 By using our services, you acknowledge and agree to this Privacy Policy.

Acknowledgment and Agreement

By signing below, I, the undersigned, acknowledge that I have read, understand, and agree to all the terms and conditions outlined in this agreement, including but not limited to the risks, responsibilities, disclaimers, confidentiality, copyright protection, and the waivers of liability. I confirm that I have been provided with all relevant information, had the opportunity to ask questions, and voluntarily consent to proceed with the Hyperbaric Oxygen Therapy (HBOT) treatment offered by Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting. I acknowledge that my participation in HBOT is entirely voluntary, and I am seeking this service of my own free will and on my own behalf. I understand that I am responsible for disclosing all relevant medical conditions and contraindications and that I assume all risks associated with this treatment. I further agree to comply with all rules, policies, and safety protocols provided by Legendary O2: Hyperbaric Rentals & O2 Wellness Consulting, and I consent to the terms regarding copyright protection, as outlined in this document.

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