Terms and Conditions

1. Scope and acceptance

These Terms govern membership in the National Hyperbaric Safety Association (NHSA), participation in NHSA educational programs, access to association resources, and authorized use of NHSA membership or credential designations. “You” means the accepting individual and, where that individual has authority to bind an organization, that organization. Do not accept on an organization’s behalf without authority.

By affirmatively accepting these Terms during application, enrollment, or renewal, you agree to comply with them. Membership and applicable services are conditional on acceptance. Merely visiting this webpage is not acceptance of a release. Separate course, examination, refund, and event rules disclosed before enrollment also apply and cannot reduce these safety obligations.

2. Membership eligibility and continuing duties

Membership is open to clinics, providers, technicians, administrators, manufacturers, inspectors, and others involved in hyperbaric operations who uphold these standards. Membership is conditional, not automatic. Applicants must provide accurate identity, qualifications, equipment, facility, and conflict-of-interest information and promptly correct material changes.

Individual members must be at least 18. Organizations must designate an accountable representative and implement the applicable requirements across the facilities, personnel, equipment, and services they represent as NHSA-affiliated. Duties apply continuously and according to role. Membership does not authorize clinical practice.

3. Patient safety first

Place patient safety above convenience, cost, productivity, marketing, or commercial interests. Safety First, Efficacy Second! This priority does not excuse ineffective care or unsupported claims. Stop any activity when equipment, staffing, patient suitability, oxygen controls, or emergency readiness cannot support safe operation. No revenue target, patient request, certificate, or NHSA resource overrides this obligation.

Do not pressure staff to bypass checks, conceal incidents, continue unsafe treatment, or act outside their competence or legal scope. Staff must be able to raise concerns and stop unsafe activity without retaliation.

4. Approved equipment

Operate or promote for human hyperbaric treatment only FDA-cleared chambers intended for human occupancy, with documented compliance with applicable ASME requirements and ASME PVHO-1. This is an NHSA membership standard, not a representation that every jurisdiction imposes identical requirements.

Maintain model-specific clearance records, manufacturer identification, pressure-vessel documentation, operating limits, installation records, inspections, and maintenance history. FDA establishment registration, device listing, or a supplier’s statement alone does not establish clearance. Clearance does not validate every advertised indication.

Any NHSA chamber list is a reference, not a warranty or substitute for independent verification. Listing does not excuse unsafe condition, unauthorized modification, missing documentation, or noncompliant installation. Resolve safety deficiencies before operation.

5. Medical oversight and prescriptions

Facilities providing hyperbaric oxygen treatment must designate an appropriately licensed and qualified medical director responsible for clinical protocols, patient suitability, and medical oversight. A nominal appointment is insufficient. Oversight and emergency availability must suit the setting and comply with applicable law.

Every hyperbaric oxygen treatment requires a patient-specific prescription or order and treatment plan from a licensed provider authorized to prescribe in that jurisdiction. Document assessment, contraindication screening, indication, pressure, oxygen delivery, duration, frequency, monitoring, and reassessment. General protocols, certificates, membership, and patient requests are not prescriptions.

Treating professionals retain responsibility for lawful, evidence-informed decisions about emerging or off-label applications, informed consent, documentation, and monitoring. NHSA education is not a patient-specific treatment recommendation.

6. Training and competency

Personnel must complete recognized training appropriate to their duties and demonstrate equipment-specific competency before independent operation. Those actively pursuing training may participate only within legal limits and under direct supervision of a qualified, competent professional. Enrollment alone does not authorize independent practice.

Maintain records of training, supervised practice, competency assessments, emergency drills, and continuing education. Reassess after material changes, extended absence, or safety concerns. A certificate does not replace licensure, employer authorization, manufacturer instruction, or demonstrated competence.

7. Safety protocols and emergency readiness

Maintain and follow written procedures covering screening, informed consent, operational checklists, oxygen and fire safety, prohibited items, grounding, communication, observation, compression and decompression, cleaning, inspection, maintenance, and emergency response. Follow manufacturer instructions and device-specific restrictions. Do not introduce unauthorized materials, ignition sources, electrical devices, or modifications.

Provide adequate staffing, assign responsible personnel, and conduct documented drills. Maintain workable responses to fire, oxygen exposure events, power loss, pressure-control failure, clinical deterioration, evacuation, and emergency transfer. Patient supervision must match the device, treatment, and clinical need. An educational checklist does not replace a complete facility safety program.

8. Laws and local authority requirements

Comply with applicable federal, state, and local laws, scope-of-practice rules, medical-device requirements, oxygen-handling rules, fire and building codes, and inspections. Apply the editions of NFPA 99 and other standards adopted by the relevant authority, together with applicable manufacturer requirements and NHSA standards.

Cooperate with authorities having jurisdiction and promptly address deficiencies. NHSA membership, certificates, opinions, or training are not governmental approval, facility licensure, or code inspection. Suspend an affected activity and obtain qualified guidance when requirements conflict or their application is uncertain.

9. Professional integrity

Protect the credibility, accessibility, and long-term viability of hyperbaric medicine. Represent credentials, membership, equipment, outcomes, and evidence accurately. Do not guarantee cures, conceal material risks, misstate FDA clearance, use unearned titles, or imply endorsement beyond an expressly documented NHSA designation. Disclose relevant financial conflicts. Never falsify attendance, examinations, competency assessments, prescriptions, incident reports, or compliance records.

10. Safety review and records

Maintain records sufficient to demonstrate compliance and meet applicable retention duties. On reasonable request, supply relevant credential, equipment, training, inspection, policy, insurance, and corrective-action documentation. Cooperate in good faith with complaints, safety reviews, and verification. Do not obstruct, retaliate, or knowingly provide false information.

Do not send identifiable patient records through ordinary forms or email. Use de-identified information where possible. Before disclosing protected information, establish a lawful basis, minimum-necessary scope, secure channel, and required agreements. These Terms do not grant unrestricted access to patient information.

11. Incident reporting and corrective action

Notify NHSA without undue delay and within 24 hours of learning of a death, serious injury, chamber fire, major pressure-system failure, or governmental suspension materially connected to your hyperbaric activities. Provide known, non-identifying facts and supplement as facts become available. Report material near misses and significant safety deficiencies promptly.

Protect patients, preserve evidence, and fulfill mandatory reporting duties. Reporting to NHSA does not replace emergency response, FDA reporting, insurer notification, or regulatory reporting. Privacy and confidentiality obligations still apply.

Immediately stop affected unsafe activity, investigate contributing factors, and document corrective action and reassessment. NHSA may require a corrective-action plan, outside inspection, further training, or other evidence before restoring privileges. NHSA cannot authorize resumption of treatment or override an authority’s restriction.

12. Suspension and termination

NHSA may deny, condition, suspend, or terminate membership or access for material noncompliance, unsafe practices, misrepresentation, noncooperation, credential misuse, or conduct threatening patients or the integrity of hyperbaric medicine. Imminent safety risk, serious dishonesty, or unlawful activity may justify immediate interim suspension without advance notice.

NHSA will provide written grounds and required corrective action, subject to lawful confidentiality limits. Members may respond and request review within 15 calendar days. A reviewer without a material conflict will consider the available information and issue a written determination. Suspension continues during review unless NHSA states otherwise. Mandatory procedures under law and NHSA governing documents control where they require additional protections.

Upon suspension or termination, stop representing current membership and stop using membership marks. Return or remove materials as directed where authorized. Credential changes follow the applicable program rules. Membership discipline does not authorize revocation of another body’s credential.

13. Independent status and branding

Membership, instruction, referral, or a certificate does not by itself create agency, partnership, employment, a supervisory relationship over independent practice, or authority to bind NHSA. Do not claim NHSA manages, insures, supervises, or guarantees your services.

Use NHSA names, logos, and credentials only with written permission and within the authorized scope. A directory listing or membership designation is not accreditation or proof of ongoing compliance. NHSA may verify and accurately report membership status and disclose safety information when lawfully required or appropriately authorized.

14. Real risks of hyperbaric activities

HYPERBARIC OXYGEN THERAPY AND CHAMBER OPERATIONS INVOLVE REAL RISKS, INCLUDING SERIOUS INJURY, PERMANENT DISABILITY, AND DEATH. Hazards include fire and burns in oxygen-enriched environments; pressure-related injury to ears, sinuses, lungs, and other tissues; oxygen toxicity and seizures; visual changes; equipment or pressure-control failure; anxiety or claustrophobia; and complications from underlying conditions. This list is not exhaustive. Training and precautions reduce risk but cannot eliminate it.

Obtain appropriate medical assessment and activity-specific informed consent before treatment or chamber activities. No person must undergo pressurization merely to accept these Terms. Hands-on exposure requires its own screening and activity-specific agreement. These Terms are not patient treatment consent or a substitute for individualized disclosure.

15. Responsibility for professional activities

YOU RETAIN FULL RESPONSIBILITY FOR YOUR OWN ACTS AND OMISSIONS AND FOR THE PEOPLE AND OPERATIONS FOR WHICH YOU ARE LEGALLY RESPONSIBLE. This includes patient selection, prescriptions, clinical judgment, dosing, staffing, supervision, competency, equipment selection, installation, maintenance, emergency readiness, recordkeeping, advertising, and compliance.

NHSA provides education, resources, and association services. It does not take over your duty of care, act as your medical director, approve individual treatments, or monitor daily operations. Educational statements, example protocols, templates, examinations, membership, and certificates do not replace current professional judgment, authoritative instructions, or legal duties.

AS BETWEEN YOU AND NHSA, RESPONSIBILITY FOR INDEPENDENT CLINICAL AND OPERATIONAL DECISIONS REMAINS WITH THE PROFESSIONALS, FACILITIES, AND OTHERS WHO MAKE OR CONTROL THOSE DECISIONS. NHSA is not responsible merely because someone attended its training or used its resources. This allocation does not extinguish patient rights or excuse anyone’s own legally actionable conduct.

16. Limited release and assumption of responsibility

To the fullest extent permitted by law, you release NHSA and its directors, officers, employees, instructors, and authorized volunteers from claims belonging to you arising from your independent application, misapplication, or failure to apply NHSA educational information, or from your independent practice or operations. This does not waive claims belonging to patients or other nonparties.

You acknowledge the risks above and assume responsibility for evaluating them and determining your qualifications and authority to act. This provision does not release NHSA from gross negligence, recklessness, intentional misconduct, or nonwaivable duties. It is not a blanket release of NHSA’s own negligent conduct during hands-on training. Any proposed release for that activity requires a separate, specific agreement.

17. No guarantee of outcomes

NHSA does not warrant that education, membership, or certification will prevent harm, ensure regulatory compliance, produce clinical results, qualify someone for licensure, or establish insurance reimbursement. Resources may require adaptation and updating. Independently verify suitability before use. No disclaimer reduces NHSA obligations that law makes nonwaivable.

18. Indemnification and insurance

To the fullest extent permitted by law, you will defend, indemnify, and hold harmless NHSA and its directors, officers, employees, instructors, and authorized volunteers against third-party claims, damages, liabilities, and reasonable defense costs to the extent caused by your breach, negligence, unlawful conduct, misrepresentations, or independent hyperbaric practice or operations, including acts of persons for whom you are legally responsible.

This duty excludes the protected person’s own negligence, gross negligence, recklessness, intentional misconduct, and nonindemnifiable liability. Allocation reflects the parties’ respective responsibility. NHSA must give reasonably prompt notice and cooperate in the defense. Late notice excuses duties only to the extent of actual prejudice. Settlement cannot impose an admission, nonmonetary duty, or unreimbursed payment on a protected party without written consent, not unreasonably withheld.

Maintain professional, general, product, and other liability insurance appropriate to your role, operations, and legal requirements, and supply reasonable evidence on request. Membership provides no insurance. Insurance does not reduce responsibility.

19. Limitations on damages

TO THE MAXIMUM EXTENT PERMITTED BY LAW, NHSA WILL NOT BE LIABLE FOR INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES ARISING FROM THESE TERMS OR EDUCATIONAL RESOURCES, INCLUDING LOST PROFITS OR BUSINESS INTERRUPTION.

For claims subject to lawful contractual limitation, NHSA’s aggregate liability under these Terms will not exceed the greater of $100 or the amount you paid NHSA for the service giving rise to the claim during the preceding 12 months. These limits do not apply to NHSA’s gross negligence, recklessness, intentional misconduct, personal injury or death caused by its negligence, or any nonwaivable liability or remedy. Mandatory privacy and consumer rights remain protected.

20. Intellectual property

NHSA retains rights in its educational materials, examinations, forms, logos, and resources. Unless a written license permits broader use, resources are for your authorized learning and internal operations. Do not sell, redistribute, alter credentials, publish examinations, or misrepresent modified materials as NHSA-approved. You remain responsible for adapting internal documents to your operations and obtaining appropriate review.

21. Changes and governing law

Changes apply prospectively with a revised version and effective date. Material changes to liability, membership duties, or dispute provisions require notice and renewed affirmative acceptance before application to an existing member. No change retroactively releases an accrued claim. Emergency safety restrictions may take effect immediately when reasonably necessary, with prompt notice.

Arizona law governs except where mandatory law requires otherwise. Subject to nonwaivable jurisdiction and venue rights, disputes may be brought in state or federal courts serving Maricopa County, Arizona. These Terms do not impose mandatory arbitration or waive jury-trial rights. Unenforceable provisions are severable to the extent lawful. Failure to enforce once is not a continuing waiver. Responsibility, intellectual property, and lawful liability-allocation provisions survive termination as applicable.

22. Contact and legal notices

National Hyperbaric Safety Association, 3550 N Goldwater Blvd #1079, Scottsdale, AZ 85251. Email: [email protected]. Contact coordinator: Hannah Stephens. Send safety concerns promptly. Email and text messaging are not emergency response services. Contact emergency services for immediate assistance.

23. SMS terms

NHSA offers an optional SMS program for consenting adults. Depending on selected consent, messages may include application and membership updates, inquiry responses, training information, and separately authorized promotional or association announcements. Message frequency varies. Message and data rates may apply.

SMS consent is voluntary and not a condition of membership, purchase, donation, enrollment, or services. Provide a number you own or are authorized to use and notify NHSA of changes. Messages must remain within the consent provided and applicable law. Do not enroll another person without authorization.

Reply STOP to unsubscribe. You may receive one confirmation. Further program messages require a new valid opt-in, except communications otherwise permitted by law. Reply HELP for assistance or email [email protected]. Carriers are not liable for delayed or undelivered messages. Delivery is not guaranteed. Do not use this program for emergencies or confidential patient information.

The Privacy Policy explains data use and SMS consent protection. New messaging purposes require any additional consent mandated by law. Accepting membership Terms does not authorize marketing texts.

24. Affirmative acknowledgments

Membership acceptance: I have read and agree to the NHSA Terms and Conditions, including continuing safety requirements, documentation duties, and suspension or termination provisions. My application is accurate, and I am authorized to accept for any organization identified.

Responsibility acknowledgment: I understand that HBOT and chamber operations can cause serious injury, permanent disability, or death. I acknowledge my independent professional and operational duties and have read Sections 14 through 19, including the limited release, indemnity, and damages limitations. NHSA training or membership does not transfer my responsibilities to NHSA or waive patient rights.

NHSA requires affirmative acceptance during application, enrollment, or renewal. Optional SMS consent must be obtained separately. Publication of these Terms alone does not establish that any existing member has accepted them.