HBOT & Treatment Self Assessment

I confirm that all information I have provided is accurate and complete to the best of my knowledge.

I understand that HBOT is a supportive wellness and recovery therapy. It is not intended to diagnose, treat, cure, or prevent any disease. Individual results vary and are not guaranteed.

I understand there are known risks associated with HBOT, including barotrauma, oxygen toxicity at high exposures, and, rarely, seizures.

I acknowledge the 5-minute late rule, 24-hour no-fly protocol, no-refund policy, and shared chamber. I agree to Holina Clinic Terms & Conditions.

I consent to my personal and health information being stored and used by Holina Clinic for clinical assessment and treatment planning, in accordance with Thai PDPA.

Clinical Intake Form

HBOT Clinical Intake Form

Personal Information

Reason for HBOT

Medical Risk Assessment

Medications & Supplements

Lifestyle

Expectations & Preferences

Patient Declaration

You're cleared to proceed

A consultation call is recommended

HBOT may not be suitable at this time