Eileen C. Comia, M.D.
35 Jolley Drive Suite 102
Bloomfield CT 06002
Tel (860)242-2200
Fax (860)242-2212
We have adopted the following policies for HBOT sessions in our Center.
Please arrive at least 30 minutes prior to your therapy session.
All persons receiving treatment must do a consultation with Dr. Comia prior to beginning therapy.
Caregivers who wish to accompany a patient in the chamber must complete a separate Informed
Consent form, and be cleared from any contraindications to being inside the chamber.
Please bring a clean bedsheet and a pillow so you may be comfortable inside the chamber.
An oxygen mask will be provided. Patients are responsible for the care, cleaning, and storage of their
own oxygen mask. Please bring a plastic bag (Ziploc) to store your oxygen mask for reuse in your
next dive. Properly label the bag.
To minimize fire hazards in the chamber:
Do not use any perfume/cologne, oils, lotion (after-shave, body), hair spray, nail polish, and
petroleum-based products (such as Vaseline) prior to therapy session.
No electronic equipment (e.g. cell phones, laptop, video games, watch, etc.) will be allowed
in the chamber. Reading a book/journal is allowed in the chamber.
Do not take any flammable items (such as lighters, matches) into the chamber.
No food or drink allowed inside the chamber. (Exception: A sippy-cup for small children will be
allowed to help open the ear duct when the pressure rises.)
Please do not bring jewelry or other valuables into the chamber.
Please call the office at least 24 hours prior to your session if you need to cancel/reschedule.
In full knowledge of the afore-mentioned statements, I understand and agree to abide by the policies
noted above.
Date of Birth
Date Signed
Printed Name
Patient Signature
Parent/Legal Guardian Signature, if patient is a minor