PLEASE FILL OUT ALL THE NECESSARY FORMS. THE LINKS TO EACH FORM IS BELOW

Thank You For Your Cooperation

• • Informed Consent for Hyperbaric Oxygen Therapy • Authorization· To Use or Disclose my health Information • Photograph/Video Release Form and Assignment • To our Patients:Neubauer Hyperbaric Neurologic Center • Estimate of Charges • Acknowledgement of Receipt of Notice of Privacy Practices • Instructions for Patients Preparing to Take Hyperbaric Oxygen Therapy   Please read Carefully Sign and Return!

H.B.O.T
Hyperbaric Oxygen Therapy is a method of safety delivering high doses of oxygen to the body. It is done by breathing 100% oxygen through a pressurized chamber.The pressure inside the chamber causes the oxygen you breathe to be dissolved at greater levels in your blood, spinal fluid, lymph fluid and all tissues. The atmosphere pressure prescribed by the doctor will target your health concerns, according to the protocol for your health needs.

METHODS OF EQUILIZING PRESSURE IN YOUR EARS
This will be addressed in detail during your personalization orientation session, and informational package.The pressure is much like the feeling of fullness you experience while flying. Our staff has much experience of chamber operation and is well versed in equalizing techniques.

PRIVATE SESSIONS, DETAILED ORIENTATION, AND SLOW
COMPRESSION AND DECOMPRESSION ARE THE KEY TO OUR SUCCESS.
We will encourage you to practice equalizing your ears by yawning, swallowing water using a sports bottle, prior to starting your session. We treat children who have head trauma, near drown or have trachea tubes as well as twins and triplets without any problem.There are certain requirements to prepare for entering the Hyperbaric Oxygen Therapy (HBOT)chamber. If you have any questions concerning these guidelines, please ask the chamber operator.

YOUR ATTENDANCE
We request that you arrive for your appointment on time. However, actual HBOT sessions can only
be timed due to the nature of the treatment. We take great care to make sure each patient's session
is comfortable and to meet each patient's individual needs. If you are unable to attend for any
reason, just give us a call so that we may make room for other patient's.While in the chamber you may watch movies, listen to tapes or cd's, or sleep. We provide a safe private and productive environment.

For your peace of mind, we do not treat contagious disorders!