Vadma Screening
by Sentinel

What is your first name?

What is your last name?

Which age range do you fall into?

How do you describe your sex or gender? (optional)

Is there any possibility that you are currently pregnant?

High blood pressure (diagnosed or medicated)

Diagnosed heart condition or unexplained cardiac symptoms

Do any of the following currently apply to you?

(Select all that apply)

Are you currently taking any prescription medication?

Blood thinning medication (e.g. warfarin, apixaban, rivaroxaban)

Are you currently taking any of the following medications?

How familiar are you with deliberate cold / heat exposure (cold showers, cold water, ice baths, sauna)?

Are you taking any medication that makes you feel dizzy, drowsy, light-headed, more likely to faint or affects your balance or awareness?

Which of the following medications do you currently take?
(Select all that apply)

Do you feel well enough to participate today?

I understand that no wellness practice can guarantee specific physical, emotional, neurological or psychological outcomes, and that individual experiences vary.

I understand that physical or emotional responses experienced during or after a Vadma session may have a variety of causes and should not automatically be interpreted as evidence of healing or trauma release without appropriate clinical assessment where necessary. 

I understand that if I experience severe dizziness, loss of consciousness, chest pain, difficulty breathing, confusion, weakness, changes in vision or speech, or any other concerning symptoms during or after my session, I should seek medical attention.

I have had the opportunity to ask questions about this practice and I feel I have enough information to decide whether I wish to proceed. 

Vadma Screening by Sentinel

What is your first name?