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Treating the Toughest Cases of Depression and Brain Illness

Blood Sugar Disclosure Form

Blood Sugar Disclosure

This letter is to inform you that your blood sugar could drop in the Hyperbaric Chamber. By signing this form you are confirming that you are fully aware that this could happen, and you will make sure to have some form of sugar before and after your treatments. It will be your responsibility to monitor your blood sugar. If you feel dizzy at anytime please let us know immediately. We will provide Glucose Tablets and juice at your request.

 

Furthermore, if you are driving a vehicle we will test your blood sugar before you leave. We would like for your blood sugar level to be 95 or higher before you drive. If you choose not to have your blood sugar tested, then you take full responsibility of any consequence of low blood sugar.

 

Please Sign Below:

Name(Required)

847-236-9310