Personal details

Full Name

Date of birth

Telephone number

Email

Home addressEmail

Email

Delivery address if differentEmail

Email

Collection address if differentEmail

Email

Have you been referred by a health care professional?Email

Email

Body region to be treatedEmail

Wrap required if knownEmail

Requested hire start date and periodEmail

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Screening

Game Ready combines cold therapy and compression therapy and is commonly used as part of post-operative recovery where cold and compression are appropriate. However, it may not be suitable for everyone. Please answer the questions below carefully.

Do any of the following apply to the area being treated, or to your general medical history?

Acute inflammatory phlebitis
Current or previous deep vein thrombosis or pulmonary embolism
Increased risk of DVT or PE including recent prolonged bed rest
Significant vascular disease
Poor circulation
Arteriosclerosis or ischaemia
A condition where increased venous or lymphatic return is not advised, for example active cancer in the affected limb or region
Significant cold sensitivity
Previous frostbite in the area being treated
Diabetes affecting circulation or sensation
Cryoglobulinaemia or another cold-related blood disorder
Reduced sensation
Numbness or neurological impairment in the area
Cardiac insufficiency or congestive heart failure
Uncontrolled blood pressure concerns
Being advised not to use cold therapy or compression therapy, or being unsure whether Game Ready is appropriate

No, none of these apply

Yes, one or more apply

I am unsure

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The Wound

Do you have any of the below in the area where the wrap will be applied?

Uncovered open wound
Active bleeding
Infection
Rash
Skin breakdown or skin condition

No, none of these apply

Yes, one or more apply

I am unsure

Have you had recent surgery to the area being treated?EmailNoYes - My surgical wound is closed and/or appropriately covered with a dressing, and I have not been advised by my surgeon, consultant, physiotherapist or GP to avoid cold therapy or compression therapy.

Please tick to confirm:EmailThe information I have provided is accurate to the best of my knowledge, that I will only use the Game Ready unit for my self and for the body region discussed with Atherapy. I will follow the instructions provided by Atherapy and/or the manufacturer. I will stop using the unit and contact Atherapy if I experience increased pain, swelling, skin changes, numbness, burning, excessive cold sensitivity or any other concerning symptoms. I confirm that I will not use the wrap directly over uncovered open wounds, infections, rashes, sores or areas of skin breakdown, that any surgical wound will be closed and/or appropriately covered before use. I will not lend, sell, alter, repair or misuse the equipment, and I am responsible for returning the Game Ready unit, wrap, hose, power supply and carry bag in good working order.

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Hire Agreement and Fee

By signing this form, I agree to the following hire terms. The Game Ready unit remains the property of Atherapy Limited, that the hire period is either 14 days or 28 days from the agreed start date, that the unit must be returned by the agreed return date unless an extension has been approved in writing, and that if the unit is returned late, Atherapy may charge an additional hire fee. If the unit, wrap, hose, power supply, bag or accessories are damaged, lost, incomplete or not returned, Atherapy may charge the saved/tokenised card to recover the relevant cost. Atherapy will notify the patient before applying any additional charge. The unit must be used only in accordance with Atherapy and manufacturer instructions and must not be taken outside the UK without written permission from Atherapy.

Hire Fee

Atherapy uses Square to process hire payments and securely tokenise payment cards. By signing below, I authorise Atherapy to send me a Square payment request for the agreed hire fee, securely tokenise/save my payment card through Square for the duration of the hire, use the tokenised card only if additional charges become due because the Game Ready unit or accessories are returned late, damaged, incomplete, lost or not returned, and contact me before any additional charge is applied. I understand that Atherapy will not manually store my full card details.

Please complete all fields. You may cancel this authorisation at any time by contacting us. This authorisation will remain in effect until cancelled.

Credit Card Information

Card Type: EmailMaster CardVISAAMEXOther

Email

I consent to Square card tokenisation for the purposes of Game Ready hire.

Personal details

Screening

The Wound

Hire Agreement and Fee

Hire Fee

Testimonial

Patient Experience

ACL Reconstruction –
4 Weeks Post-Op

Using Game Ready in the first few weeks after my ACL reconstruction made a noticeable difference in managing swelling and keeping the knee comfortable

The Game Ready ice machine has made a real difference to my recovery speed.

Game Ready Hire Request

Advanced Cold Compression Therapy with Atherapy

Personal details

Screening

The Wound

Hire Agreement and Fee

Hire Fee

Testimonial

Patient Experience

ACL Reconstruction – 4 Weeks Post-Op

Using Game Ready in the first few weeks after my ACL reconstruction made a noticeable difference in managing swelling and keeping the knee comfortable

The Game Ready ice machine has made a real difference to my recovery speed.

ACL Reconstruction –
4 Weeks Post-Op