top of page
Vitae Vi - WOW Clinic-11.JPG

We value your health and safety!

We ensure our workshops, classes and treatments provide a safe environment for all our clients. We do require our clients to be transparent when filling in their health and safety form.

Thank you for entrusting us with your safety, and please get in touch with us if you have any questions.

Our Health & Safety Form

If you have any questions, please get in touch.

Please fill out the following form in order to participate in our workshops, classes and treatments.


Vitae Vi see to it that the Wim Hof Method activities are carried out safely and correctly and provided by a Certified Instructor. However, Vitae Vi cannot assess the health risks particular to individual participants. Participants are notified about the health risks, as outlined below and Vitae Vi point to their personal responsibility and advise participants to consult their doctor or medical practitioner should the medical questionnaire prompt any potential issues. It is ultimately up to the participant to determine whether they are fit to take part.


Whilst we want as many people as possible to experience the Wim Hof Method, for health and safety reasons, the method isn’t suitable if:

  • You are under 18 years of age.

  • You are pregnant or breast-feeding.

  • Have epilepsy.

  • Suffer from high-blood pressure or coronary heart disease. (or any other heart issues)

  • Have a history of serious health issues. (i.e. stroke, heart failure, kidney failure)

  • Have Raynaud’s Syndrome. (Type 2)

  • Have recently had an operation.

  • Suffer from migraines (this is a personal choice as cold can sometimes trigger them)

If you have any health concerns or any serious medical issues, please consult with a healthcare professional or your GP and contact your Wim Hof Method Instructor with any questions BEFORE attending the workshop. This is for your own safety.

Do you consider yourself to be healthy?
Do you currently suffer from any form of auto-immune disease – such as rheumatism, MS, Crohn’s disease, diabetes, asthma etc.?
Are you taking any form of medication? If so, please explain.
Do you have or know of any medical conditions that your Wim Hof Instructor should know about? If you doubt your ability to attend, please contact your healthcare professional or GP for advice. This information will be kept confidential and for your own safety
Do you have any allergies including food, or environment?

Who should I contact in an emergency (next of kin) – Please provide a name and contact number:

Additional questions:


I certify that I understand that the practice of breathwork and cold-water exposure carries some degree of risk and hazard, that may result in physical injury. I also understand that entering an ice-bath or exposure to cold water in any form is optional and at my own risk. I understand the dangers associated with the effects of the cold during and after exposure to it and I confirm that I am in good physical and mental condition. I shall not hold Vitae Vi and the Wim Hof Method Instructor liable for any damages and/or injury resulting from participation in any activity promoted by them.

I understand that it is my own responsibility to consult with my GP or a medical professional should I feel I need to prior to partaking in any workshop, retreat, event, or any session and by completing the information below I have made Vitae Vi aware of any health conditions and concerns and/or current injuries. Furthermore, I participate in any activity provided by Vitae Vi at my own risk.

I further understand that it is my responsibility to seek advice from my GP or a medical professional before partaking in any form of cold-water exposure. I understand that I am responsible for my own safety whilst getting in and out of cold water or an ice bath and will follow any advice or guidance given by Vitae Vi personnel.

By fully completing and dating this declaration, I confirm that I am physically fit and capable of participating in workshops, retreats, events or activities. I agree that I fully understand the contents and meaning of the above provisions, and I declare that I am over 18 years of age and fully capable in providing my consent.


I have read Vitae Vi’s updated terms and conditions and privacy policy online for customers and how Vitae Vi will process my personal data. Vitae Vi’s privacy policy can be found at Unless otherwise stated, you are happy to have photographs and video taken and used by Vitae Vi in marketing materials, online and via social media.

I understand and accept this health and safety form.

Please use your mouse to sign on the line.

Thanks for submitting!
Vitae Vi's Wim Hof Method class set up at the WOW Clinic

Please get in touch if you have any questions.

bottom of page