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Contraindications to MAH Ozone Therapy
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Other chronic conditions:
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List any medications or supplements you take regularly:
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Primary reason for seeking MAH ozone therapy: (Check all that apply)
Other: If yes to any of the above, please give more details:
When was your last blood test? Approximate date:
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What is MAH Ozone Therapy?
Major Autohemotherapy (MAH) is a wellness therapy in which a small amount of blood is drawn up in to an I-set, a blood thinner either heparin or sodium citrate is added and mixed with medical-grade ozone,then returned to the bloodstream. It is believed to:
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Support immune function and oxygen utilization
Reduce inflammation and oxidative stress
Improve energy levels and circulation
Support the body’s natural detoxification
Common Mild Side Effects:
Mild headache or dizziness.
Herxheimer reaction – Flu like symptoms often temporary and related to oxidative stress
Local irritation at the injection site such as redness, bruising, or discomfort.
Less Common but Possible Side Effects:
Low blood pressure or light headedness due to vasodilation effects of ozone.
Temporary increase in pain or inflammation due to a response to immune activation cell breakdown (homolysis)
Dark or Red Urine due to either detoxification & increased oxidative stress or red blood
Rare but Serious Risks:
Air embolism – If ozone is improperly administered into a vein in gas form
Oxidative stress overload if antioxidant reserves are depleted, leading to excessive oxidative damage.
Electrolyte imbalances if detoxification is too rapid.
Client Acknowledgment & Legal Disclaimer
By signing this form, I acknowledge and agree that:
I am choosing to undergo MAH Ozone Therapy voluntarily and understand that this is a complementary wellness service, not a medical treatment.
I understand that this therapy is NOT intended to diagnose, treat, or cure any disease and does not replace medical advice or treatment from a licensed healthcare provider.
I have fully disclosed my medical history, medications, and conditions.
I understand that while ozone therapy has been widely used for wellness purposes, it is not FDA-approved for specific medical conditions.
There are no guaranteed results, and individual responses vary.
I have been given the opportunity to ask questions and satisfied with the explanations provided.
I assume full responsibility for my choice to receive MAH Ozone Therapy and release The Hive Ozone from liability, except in cases of gross negligence or misconduct.
Consent for Treatment​
I have read and understood the information provided and have been fully informed about the treatment and potential side effects. I consent to receive MAH Ozone Therapy and assume full responsibility for my participation.
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