ASF Standards · Fitness & Wellness · Standard 8
Standard 8 — Medical Tourism
Criteria in this standard
8.1 — Pricing Transparency for International Wellness Guests
8.2 — Language Access for International Guests
8.3 — Booking Agent and Facilitator Verification
8.4 — International Guest Complaint and Redress Process
8.5 — Travel Fatigue Is Factored Into Program Intensity, Not Ignored
8.6 — Extreme or High-Intensity Wellness Programming Requires Genuine Medical Oversight
8.7 — Thermal and Mineral Spring Facilities Follow Updated Safety Regulation
8.8 — Travel Insurance and Emergency Evacuation Coverage Is Verified
8.9 — Substance-Related Wellness Practices Follow Genuine Safety Disclosure and Legal Compliance
8.10 — Facilitator Representations About Program Intensity Match Actual Reality
8.2 — Language Access for International Guests
8.3 — Booking Agent and Facilitator Verification
8.4 — International Guest Complaint and Redress Process
8.5 — Travel Fatigue Is Factored Into Program Intensity, Not Ignored
8.6 — Extreme or High-Intensity Wellness Programming Requires Genuine Medical Oversight
8.7 — Thermal and Mineral Spring Facilities Follow Updated Safety Regulation
8.8 — Travel Insurance and Emergency Evacuation Coverage Is Verified
8.9 — Substance-Related Wellness Practices Follow Genuine Safety Disclosure and Legal Compliance
8.10 — Facilitator Representations About Program Intensity Match Actual Reality
8.1
Pricing Transparency for International Wellness Guests
Non-Negotiable
An international guest receives a complete, written, all-inclusive cost estimate before travel is booked — covering the full program and commonly needed extras — not a partial quote that grows once the guest has already committed to travelling.
In plain terms: International wellness guests get a complete written cost before booking travel — programme, accommodation, meals, treatments, transfers, the usual extras — with nothing hidden.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Full | Full |
Why this matters
A guest who flies in for a week-long wellness retreat cannot walk away when the bill is double the quote. Add-on treatments, mandatory consultations, 'facility fees,' transfers, dietary supplements — each undisclosed extra is a breach of trust with a guest who has no recourse. An all-inclusive written estimate — everything included, everything excluded, what could change and why — in the guest's language, before travel is booked, is the basis of an ethical wellness tourism business.
What good looks like
- Every international guest receives a complete, written, all-inclusive estimate before booking.
- The estimate genuinely covers commonly needed extras, not just the base program fee.
- A transparent, defined process exists for any genuine cost change.
Common failure modes
- Estimates are verbal, partial, or given only after the guest has already committed to travel.
- The quote covers only the base program, with predictable extras added later.
- Cost increases appear on the final bill without prior communication.
Worked example
In practice
A 1,500-member wellness centre with a residential retreat programme for international guests.
BeforeRetreat prices covered the programme. Accommodation, meals, treatments, transfers, and consultations were charged separately on departure. Guests routinely paid 40% more than quoted. Reviews cited 'hidden costs.'
ActionAn all-inclusive retreat estimate template was created per programme: programme, accommodation, all meals, included treatments, transfers, consultations — total; explicit list of optional extras with prices; conditions under which the price could change. Sent in the guest's language before booking with a signature. Any charge outside the estimate requires the guest's written agreement.
AfterThe Monitor reviewed 12 retreat guest files with signed estimates matching final invoices. Complaints about cost: none in six months. Verified.
If you are starting from zero — do this first
- Compare the last ten retreat guests' quotes to their final bills.
- Build an all-inclusive estimate template.
- Send it before booking in the guest's language.
- Require written agreement for extras.
The most common mistake: Quoting the programme and treating the accommodation as an extra.
Self-assessment questions
1. Does every international guest receive a complete, written, all-inclusive estimate before booking travel? — Written and complete, not a verbal figure that leaves room to grow later.
Evidence: Written cost estimate documentation
Evidence: Written cost estimate documentation
2. Does the estimate cover commonly needed extras, not just the base program fee? — Genuinely all-inclusive, not a narrow quote that predictably grows.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Is there a specific process for handling a genuine, unforeseeable cost change once the guest has arrived? — A defined, transparent process, not an unexplained addition to the bill.
Evidence: Cost change communication protocol
Evidence: Cost change communication protocol
Common reasons for a PARTIAL answer
- Estimates are written and complete for the primary program but not for commonly bundled extras. — A guest comparing quotes needs the genuinely full picture, not just the headline program cost.
- The estimate is provided in writing but only after initial travel arrangements are already underway. — The protective value of advance pricing depends on it arriving before the guest's negotiating position weakens.
- A cost change process exists but isn't proactively explained to guests in advance.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current pricing communication practice against genuine advance, all-inclusive standard. |
| Week 2 | Build a complete, written estimate template covering commonly needed extras. |
| Week 3 | Establish a transparent process for communicating any genuine cost change. |
| Ongoing | Audit final costs against original estimates for a sample of guests. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Cost estimate review | Reviews written estimates provided to a sample of recent international guests for completeness. |
| ASK | Guest cost experience interview | Asks a recent international guest whether their final cost matched what they were quoted before travel. |
| DOCUMENT | Cost change protocol review | Reviews the process for communicating any genuine, unforeseeable cost change. |
Supervisor tips
- Ask a recent international guest directly whether the final cost matched the original quote. — This is the clearest, most direct test of genuine pricing transparency.
- Ask to see a written estimate for a specific, real guest, not a generic template. — A real example reveals whether the practice is genuinely followed, not just documented in policy.
Evidence base
[36] WHO's guidance on financial protection in health systems identifies advance cost transparency as a determinant of genuine informed consent, a principle that applies with particular force when the guest has limited ability to seek a second opinion or negotiate after arrival.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.2
Language Access for International Guests
Non-Negotiable
International guests have access to a genuinely competent interpreter for program orientation, safety instructions, and any consent conversation — not an ad hoc arrangement using whichever staff member happens to speak some of the guest's language.
In plain terms: International guests have a competent interpreter for orientation, safety briefings, and any medical or programme discussion — not a staff member who 'speaks some English.'
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
A safety briefing the guest did not understand is a briefing not given. A programme intensity explained through gestures is a programme the guest cannot judge. A medical screening (1.1) completed in a language the guest reads poorly is unreliable. For wellness tourism, language access covers: orientation and facility rules, safety briefings for every activity, the screening and any medical conversation, programme explanation and daily instructions, and complaints. A phone interpretation service and translated materials are the minimum; language-matched staff where possible.
What good looks like
- A genuinely trained, competent interpreter is used consistently.
- Interpreter access is arranged in advance, matched to the guest's language.
- Guests can explain back key safety instructions in their own words.
Common failure modes
- Whichever staff member happens to speak some of the language is used ad hoc.
- Interpreter arrangements are improvised on the day of arrival.
- Guests cannot explain back safety instructions.
Worked example
In practice
A wellness centre receiving guests from six language groups.
BeforeOrientation was in the local language with a staff member translating informally into English. Guests from other language groups understood little. A guest misunderstood the sauna safety briefing and stayed too long, fainting. Screening forms were in English only.
ActionScreening forms and safety briefings were translated into the six main languages. A phone interpretation service covers orientation, medical conversations, and complaints. Safety briefings for each activity are delivered with translated cards and interpreter where needed. Guest-facing staff learned key phrases. Interpreter use is documented.
AfterThe Monitor reviewed translated materials, interpretation logs, and observed an orientation using the phone service. Verified.
If you are starting from zero — do this first
- List the languages of your international guests.
- Translate screening forms and safety briefings into each.
- Contract a phone interpretation service.
- Document interpreter use for medical conversations.
The most common mistake: Delivering a sauna safety briefing the guest did not understand.
Self-assessment questions
1. Is a genuinely competent interpreter used for program orientation, safety instructions, and consent conversations? — Trained interpreter competency, not ad hoc bilingual staff pressed into service.
Evidence: Interpreter engagement record
Evidence: Interpreter engagement record
2. Is interpreter access arranged before the guest arrives, not improvised on the day? — Planned in advance, matched to the guest's actual language.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Can the guest explain back key safety instructions in their own words? — Tests genuine understanding, not just that interpretation technically occurred.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
Common reasons for a PARTIAL answer
- A trained interpreter is used for arrival orientation but not for ongoing daily program instructions. — Safety guidance during the program carries real, ongoing importance, not only at arrival.
- Interpreter access exists but isn't confirmed until the guest has already arrived. — Advance confirmation avoids a scramble that risks falling back on ad hoc arrangements.
- Interpretation occurs but understanding is never actively checked afterward.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current interpreter arrangements for international guests. |
| Week 2 | Establish advance booking of trained interpreters matched to expected guest languages. |
| Week 3 | Extend interpreter use to ongoing daily program instructions, not arrival alone. |
| Ongoing | Spot-check guest understanding after interpreted safety instructions. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Interpreter engagement review | Reviews records for genuine, trained interpreter engagement, not ad hoc bilingual staff use. |
| ASK | Advance arrangement interview | Asks staff how interpreter access is arranged before an international guest's arrival. |
| OBSERVE | Guest understanding check | Checks whether the guest can explain back key safety instructions. |
Supervisor tips
- Ask specifically about interpretation for daily program safety instructions, not just arrival orientation. — This is where interpreter use most commonly lapses.
- Ask a guest to explain back a specific safety instruction in their own words. — This tests genuine understanding, not just that an interpreter was present.
Evidence base
[37] Professional interpreter use is consistently associated with improved comprehension, informed consent quality, and safety outcomes compared with ad hoc interpretation by untrained bilingual staff or fellow guests.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.3
Booking Agent and Facilitator Verification
Non-Negotiable
Any wellness tourism booking agent or facilitator referring guests to this facility is specifically verified — real business registration, a real, checkable track record — with the verification documented, not accepted based on the volume of guests they refer or how professional their marketing appears.
In plain terms: Any agent or booking platform that sends international guests is verified — real business, real track record — and bound by a written standard on what they may promise.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
Wellness tourism agents promise transformation, guaranteed results, medical outcomes. When the reality falls short, the guest blames the facility. Verification: registration confirmed; references; a signed agreement on permitted claims (no guarantees, no medical outcome promises), commission disclosure, and termination. Guests receive the facility's own programme description directly so they can compare what they were told.
What good looks like
- Each facilitator is specifically verified for legitimate registration and track record.
- Verification is documented and periodically reconfirmed.
- A specific process reviews what facilitators actually represent to guests.
Common failure modes
- Facilitators are accepted based on referral volume without specific verification.
- Verification, if it happened, was never reconfirmed after initial acceptance.
- No process exists to review what facilitators actually tell guests.
Worked example
In practice
A wellness centre receiving guests through four international agents.
BeforeAgents were engaged by email. One promised 'guaranteed 10 kg weight loss in 7 days' and 'medically supervised detox' — neither true. Guests arrived with expectations the facility could not meet. No agreements existed.
ActionAn agent verification standard was written: registration confirmed; two references; a signed agreement on permitted representations (the facility's own programme descriptions only; no guarantees; no medical claims), commission disclosure, and termination for breach. All four agents were reviewed; one terminated. Guests receive the facility's programme description directly at booking.
AfterThe Monitor reviewed three agent files with verification and agreements. Interviewed a guest who confirmed receiving the facility's own description. Verified.
If you are starting from zero — do this first
- List every agent and what they say about you online.
- Verify each one's registration.
- Sign an agreement on permitted claims.
- Send guests your own description directly.
The most common mistake: An agent promising results the facility never claimed.
Self-assessment questions
1. Is each booking agent or facilitator specifically verified for legitimate business registration and a checkable track record? — Genuine, specific verification, not accepted based on referral volume or marketing professionalism alone.
Evidence: Facilitator verification record
Evidence: Facilitator verification record
2. Is verification documented and periodically reconfirmed, not done once and assumed to remain valid indefinitely? — An active, periodically reconfirmed process, not a one-time check.
Evidence: Periodic reconfirmation record
Evidence: Periodic reconfirmation record
3. Is there a specific process for reviewing what a facilitator actually tells guests about program intensity and content? — Active oversight of facilitator representations, not an assumption they accurately represent the program.
Evidence: Facilitator representation review process
Evidence: Facilitator representation review process
Common reasons for a PARTIAL answer
- Verification happens for new facilitator relationships but isn't reconfirmed for long-standing ones. — A facilitator's legitimacy and practices can change over time even after an initial, valid verification.
- Verification covers business registration but not the accuracy of their guest-facing representations. — A legitimately registered facilitator can still misrepresent program intensity or content to guests.
- Guests occasionally arrive with expectations that don't match what the facility actually offers.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current facilitator relationships for specific verification versus assumed legitimacy. |
| Week 2 | Establish or strengthen documented verification for every facilitator relationship. |
| Week 3 | Build a periodic reconfirmation schedule and a process for reviewing facilitator representations. |
| Ongoing | Review guest expectations against program reality as an indicator of facilitator accuracy. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Facilitator verification review | Reviews verification records for business registration and track record for each facilitator. |
| DOCUMENT | Reconfirmation schedule review | Reviews whether verification is periodically reconfirmed, not a one-time check. |
| ASK | Representation review interview | Asks staff how they review what facilitators actually tell guests about the program. |
Supervisor tips
- Ask for the actual verification record for a specific, named facilitator. — A specific, documented record is the real evidence of genuine verification, not assumed legitimacy.
- Ask a recent international guest what they were told by their facilitator before arrival. — This reveals whether facilitator representations actually match program reality.
Evidence base
[38] Medical and wellness tourism governance literature consistently identifies unregulated facilitator and agent networks as a distinct risk category, separate from the operational quality of the receiving facility itself.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.4
International Guest Complaint and Redress Process
Non-Negotiable
International guests have access to a genuine complaint and redress process reachable from their home country, with real evidence complaints are addressed — not a process that functionally only works for a guest still physically present at the facility.
In plain terms: International guests can complain and seek redress from their home country — email, phone, web — and there is evidence complaints are addressed.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Full | Full |
Why this matters
A guest who returns home dissatisfied, or injured, cannot complain at the front desk. Without a remote route, they complain publicly. The process: email and web form in the guests' languages; a named person; response times; a redress policy (refund conditions, escalation). Evidence: complaints from abroad received and resolved.
What good looks like
- The complaint channel is genuinely reachable and usable from abroad.
- The channel accounts for relevant languages and time zone differences.
- Real, documented evidence shows complaints are genuinely addressed.
Common failure modes
- The complaint process functionally requires physical presence at the facility.
- No accommodation exists for language or time zone barriers.
- No documented evidence exists that complaints from returned guests are addressed.
Worked example
In practice
A wellness centre whose complaints process was in-person only.
BeforeNo remote route. Guests complained on review sites. Two injury complaints from abroad went unanswered because they arrived by email to a general inbox nobody monitored.
ActionA dedicated international complaints email and web form were created in six languages; the guest relations manager is the named contact; 3-day acknowledgement, 21-day response; a redress policy with refund conditions and an external mediation option. The route is on every booking confirmation.
AfterThe Monitor reviewed the log: 9 international complaints in six months, all responded to within timeframe, two with partial refunds. Verified.
If you are starting from zero — do this first
- Try to complain about your facility from abroad.
- Create a dedicated email and web form in guests' languages.
- Name a contact and set response times.
- Write a redress policy.
The most common mistake: Reporting no international complaints because the email goes to an unmonitored inbox.
Self-assessment questions
1. Is there a specific complaint channel genuinely reachable from the guest's home country? — Genuine remote accessibility, not a channel that functionally only works locally.
Evidence: Complaint channel documentation
Evidence: Complaint channel documentation
2. Is the complaint channel accessible in relevant languages and time zones? — Genuine accessibility accounting for real language and time zone barriers.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Is there real, documented evidence that complaints from returned guests are actually addressed? — Genuine follow-through, not a channel that exists but produces no real response.
Evidence: Complaint resolution record
Evidence: Complaint resolution record
Common reasons for a PARTIAL answer
- A remote complaint channel exists but response times are significantly slower than for on-site concerns. — A technically accessible channel that responds too slowly doesn't provide genuine redress.
- The channel is accessible by email but responses aren't genuinely timed to the guest's time zone. — Technical accessibility without genuine time zone awareness limits real, timely communication.
- Complaints are received but resolution isn't consistently communicated back to the guest.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current complaint channel for genuine remote, language, and time zone accessibility. |
| Week 2 | Establish or strengthen remote-accessible complaint intake in relevant languages. |
| Week 3 | Establish documented resolution tracking with clear communication back to the guest. |
| Ongoing | Track response times and resolution rates for international guest complaints specifically. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Complaint channel accessibility review | Reviews whether the complaint channel is genuinely reachable and usable from abroad. |
| DOCUMENT | Language and time zone accessibility review | Reviews whether the channel accounts for relevant languages and time zone differences. |
| DOCUMENT | Resolution record review | Reviews documented evidence that complaints from returned guests are genuinely addressed. |
Supervisor tips
- Ask for a real example of a complaint received from a guest after they had already returned home. — A real example reveals whether the channel genuinely functions for exactly the guests who need it most.
- Test the complaint channel's accessibility in a language other than the local one. — This directly reveals genuine language accessibility, not an assumption of it.
Evidence base
[39] Cross-border consumer redress mechanisms are identified in international tourism governance literature as a distinct requirement from domestic complaint processes, given the specific access barriers international travelers face after returning home.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.5
Travel Fatigue Is Factored Into Program Intensity, Not Ignored
Non-Negotiable
Program intensity for an arriving international guest genuinely accounts for real travel fatigue — jet lag, disrupted sleep, dehydration from flight — not beginning a high-intensity program immediately on arrival as though the guest hadn't just traveled at all.
In plain terms: A guest who arrived yesterday after a long flight does not start high-intensity training this morning — the programme accounts for jet lag, dehydration, and disrupted sleep.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
A guest who has flown twelve hours, crossed eight time zones, slept four hours, and is dehydrated is not physiologically ready for the programme they booked. Starting them at full intensity on day one causes fainting, injury, and cardiac stress. Travel fatigue must be assessed on arrival (hours travelled, time zones, sleep, hydration, symptoms) and the first day or two adapted: lower intensity, hydration, rest, gradual ramp. The programme design allows for it; the guest is told why.
What good looks like
- Program intensity genuinely accounts for real arrival fatigue.
- A specific, structured adjustment period precedes full intensity.
- Guests are specifically assessed for their actual travel impact.
Common failure modes
- Full-intensity programming begins immediately on arrival, regardless of travel.
- No structured adjustment period exists.
- Travel impact is assumed generically, not individually assessed.
Worked example
In practice
A wellness centre running seven-day intensive retreats for international guests.
BeforeThe programme started at full intensity on the morning after arrival. Guests arriving from long-haul flights regularly fainted, vomited, or dropped out on day one. Staff attributed it to 'not being fit enough.'
ActionAn arrival assessment was added: travel duration, time zones crossed, sleep, hydration, symptoms. Day one is a low-intensity orientation and hydration day for all long-haul arrivals; day two ramps to 60%; full intensity from day three. The seven-day programme was restructured to accommodate this. Guests are told at booking.
AfterThe Monitor reviewed 20 arrival assessments and adapted day-one programmes; day-one adverse events fell from 6 per month to 0. Verified.
If you are starting from zero — do this first
- Count adverse events on day one of your retreats.
- Add an arrival travel fatigue assessment.
- Make day one low-intensity for long-haul arrivals.
- Restructure the programme.
The most common mistake: Starting the retreat at full intensity the morning after a twelve-hour flight.
Self-assessment questions
1. Does program intensity for an arriving guest genuinely account for real travel fatigue, not assume full readiness immediately? — Real, deliberate adjustment for arrival fatigue, not intensity beginning as though travel hadn't occurred.
Evidence: Arrival program adjustment documentation
Evidence: Arrival program adjustment documentation
2. Is there a specific, structured adjustment period before full-intensity programming begins? — A real, defined adjustment period, not immediate full participation on arrival.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Are guests specifically asked about their own travel experience — flight length, time zones crossed — to inform this adjustment? — Genuine, individual assessment of actual travel impact, not a generic assumption applied to everyone.
Evidence: Travel impact assessment
Evidence: Travel impact assessment
Common reasons for a PARTIAL answer
- Adjustment happens for guests arriving from significantly different time zones but not for shorter, still fatiguing journeys. — Genuine fatigue can result from travel that doesn't cross many time zones, and deserves the same consideration.
- An adjustment period exists on paper but isn't consistently followed when a guest insists they feel ready. — Genuine physiological depletion doesn't necessarily match a guest's own subjective sense of readiness.
- Assessment happens but isn't genuinely used to inform the actual first-day program.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current arrival program design for genuine accounting of travel fatigue. |
| Week 2 | Establish a structured adjustment period before full-intensity programming. |
| Week 3 | Build a specific travel impact assessment informing actual first-day program design. |
| Ongoing | Confirm adjustment period practice holds even when a guest requests to begin immediately. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Arrival adjustment review | Reviews whether program intensity genuinely adjusts for arrival fatigue. |
| OBSERVE | Adjustment period observation | Observes whether a real, structured adjustment period precedes full-intensity programming. |
| DOCUMENT | Travel impact assessment review | Reviews whether guests are specifically asked about their actual travel experience. |
Supervisor tips
- Ask what a guest arriving from a long-haul flight would actually do on their first day. — A specific, real answer reveals genuine practice, not an assumption that adjustment happens.
- Ask how staff would respond to a guest insisting they're ready for full intensity immediately. — A specific, thoughtful answer reveals whether genuine physiological consideration holds against guest preference.
Evidence base
[40] A Columbia University study of business travelers found frequent and extensive travel associated with increased cardiovascular risk factors including obesity, high blood pressure, and high cholesterol, with jet lag, poor sleep, and disrupted routine establishing genuine, real physical depletion that program intensity must account for on arrival.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.6
Extreme or High-Intensity Wellness Programming Requires Genuine Medical Oversight
Non-Negotiable
Any program pushing toward genuine physical extremes — intensive detox, extended fasting, high-altitude exertion, extreme temperature exposure — is genuinely overseen by a trained medical professional, not delivered by wellness staff alone regardless of how experienced they are in non-medical wellness practice.
In plain terms: Any programme that pushes the body to extremes — prolonged fasting, intensive detox, altitude, extreme heat or cold — has a doctor genuinely overseeing it: screening, monitoring, and authority to stop.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
Extended water fasting, 'detox' protocols, high-altitude exertion, extreme heat or cold exposure, intense caloric restriction — each has caused deaths in wellness settings. They are physiological stressors that can precipitate cardiac arrhythmia, electrolyte collapse, hypothermia, heat stroke, or kidney failure, especially in people with undisclosed conditions. Medical oversight means a licensed physician: screens every participant for that specific programme, sets participant-specific limits, monitors (vital signs, bloods where indicated) during the programme, and has authority to stop it. A 'wellness consultant' is not medical oversight.
What good looks like
- Genuinely extreme programming is overseen by a trained medical professional.
- The medical professional is genuinely present or immediately accessible during the activity.
- A specific, defined threshold clearly identifies what triggers this requirement.
Common failure modes
- Extreme programming relies on wellness staff alone, without medical oversight.
- Medical input, if any, happens only in advance, not during the actual activity.
- No defined threshold exists; the need for oversight is left to informal judgment.
Worked example
In practice
A wellness centre offering a seven-day water fast and a cold-exposure programme.
BeforeThe fasting programme was run by a nutritionist. No medical screening specific to fasting. No monitoring. A guest with undisclosed heart disease developed an arrhythmia on day five; another with a history of eating disorder relapsed. The cold programme had no temperature or duration limits.
ActionA physician was contracted for all extreme programmes: fasting-specific screening (cardiac, renal, electrolytes, eating disorder history, medications); daily vital signs and electrolytes on days 3, 5, and 7; participant-specific limits; authority to withdraw a participant. Cold exposure: physician-set limits by participant, monitored sessions, exclusion criteria. Programmes cannot run without the physician's sign-off.
AfterThe Monitor reviewed the physician contract, screening records for 15 fasting participants, monitoring logs, and two withdrawals for medical reasons. Verified.
If you are starting from zero — do this first
- List every programme that pushes physiological extremes.
- For each, name the physician overseeing it. If none, stop the programme until there is one.
- Write programme-specific screening and monitoring.
- Give the physician authority to stop.
The most common mistake: A nutritionist 'supervising' a seven-day fast — that is not medical oversight.
Self-assessment questions
1. Is any genuinely extreme or high-intensity program overseen by a trained medical professional, not wellness staff alone? — Real, medical oversight specifically, not general wellness expertise substituted for it.
Evidence: Medical oversight documentation for extreme programming
Evidence: Medical oversight documentation for extreme programming
2. Is the medical professional genuinely present or immediately accessible during the actual extreme activity, not consulted only in advance? — Real, active presence or immediate accessibility during the activity itself, not a prior consultation alone.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Is there a specific, defined threshold for what counts as "extreme," triggering this requirement, not left to informal judgment? — A real, defined threshold, not an assumption staff will recognise when oversight is needed.
Evidence: Extreme program threshold definition
Evidence: Extreme program threshold definition
Common reasons for a PARTIAL answer
- Medical oversight is genuine for the most extreme offerings but the threshold isn't clearly defined for borderline programs. — A clear, specific threshold prevents genuinely risky borderline programs from falling through an undefined gap.
- A medical professional is consulted in program design but isn't genuinely present during the actual activity. — Real-time oversight during the activity itself is what actually protects a guest if something goes wrong in the moment.
- Oversight exists for programs the facility itself labels extreme but not for guest-requested intensification of a standard program.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current extreme programming for genuine medical oversight versus wellness staff alone. |
| Week 2 | Establish a specific, clear threshold defining what triggers mandatory medical oversight. |
| Week 3 | Confirm medical presence or immediate accessibility during the actual activity, not consultation alone. |
| Ongoing | Apply the threshold consistently, including guest-requested intensification. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Medical oversight documentation review | Reviews evidence of genuine medical professional oversight for programs meeting the extreme threshold. |
| OBSERVE | Presence or accessibility observation | Confirms medical oversight is genuinely present or immediately accessible during the actual activity. |
| DOCUMENT | Threshold definition review | Reviews the facility's specific, defined threshold for what triggers mandatory medical oversight. |
Supervisor tips
- Ask for the facility's specific, defined threshold for what counts as extreme programming. — A specific, real threshold reveals genuine practice, not informal judgment.
- Ask where the medical professional actually is during a specific extreme activity. — A specific, confident answer reveals genuine real-time oversight, not advance consultation alone.
Evidence base
[41] Documented analysis of the wellness retreat industry identifies a competitive push toward increasingly extreme treatment offerings, with certain extreme treatments carrying serious health risks particularly when not carried out by trained medical professionals.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.7
Thermal and Mineral Spring Facilities Follow Updated Safety Regulation
Non-Negotiable
Thermal and mineral spring bathing facilities genuinely follow current, updated safety regulation and international best practice — water quality, temperature monitoring, bather capacity — not outdated practice assumed adequate because it hasn't caused a documented problem yet.
In plain terms: Thermal pools and mineral springs follow current safety regulation — water quality testing, temperature limits, supervision, contraindication screening — not tradition.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Adapted | Adapted | Full |
Why this matters
Thermal water harbours Legionella, Pseudomonas, and amoebae that cause fatal infections. High temperatures cause fainting, arrhythmia, and — in pregnancy — fetal harm. Unsupervised pools drown. Regulation (national bathing water rules, ISO/CEN standards, WHO guidance) sets water quality testing frequency and limits, maximum temperatures, supervision requirements, and contraindication screening (cardiac disease, pregnancy, intoxication). A facility following 'what we've always done' is following the standards of the year it opened.
What good looks like
- The facility genuinely follows current, updated safety regulation.
- Water temperature is genuinely, actively monitored.
- Bather capacity is genuinely enforced, including during high demand.
Common failure modes
- Practice is outdated, assumed adequate without genuine current compliance.
- Temperature monitoring is absent or purely assumed from reputation.
- Capacity limits are ignored during high-demand periods.
Worked example
In practice
A wellness centre with a natural thermal spring pool used for decades.
BeforeWater was tested annually. Temperature was 'natural' (up to 44°C). No supervision. No contraindication screening. Two guests had fainted in the previous year; one Legionella case had been linked to the facility.
ActionThe current national thermal bathing regulation and WHO guidance were obtained. Water quality testing moved to weekly (microbiological) with defined action limits and a closure protocol. Maximum temperature set at 40°C with a cooler pool for longer immersion. A trained attendant supervises during opening hours. Contraindication signage and a screening question at check-in. Immersion time guidance posted.
AfterThe Monitor reviewed weekly water test results (all within limits), temperature logs, the attendant rota, and check-in screening records. Verified.
If you are starting from zero — do this first
- Find the current thermal bathing regulation for your country.
- Compare your water testing frequency and temperature to it.
- Add supervision and contraindication screening.
- Write a closure protocol for water failures.
The most common mistake: Testing thermal water annually — Legionella grows in weeks.
Self-assessment questions
1. Does the facility genuinely follow current, updated water quality and safety regulation for thermal or mineral spring bathing? — Real, current regulatory compliance, not outdated practice assumed adequate.
Evidence: Water quality and safety compliance documentation
Evidence: Water quality and safety compliance documentation
2. Is water temperature genuinely, actively monitored, not assumed stable without verification? — Real, active monitoring, not an assumption based on the source's general reputation.
Evidence: Temperature monitoring record
Evidence: Temperature monitoring record
3. Is bather capacity genuinely enforced, not exceeded during high-demand periods? — Real, enforced capacity limits, not capacity guidance ignored when demand is high.
Evidence: Bather capacity enforcement record
Evidence: Bather capacity enforcement record
Common reasons for a PARTIAL answer
- Water quality testing happens but not at a genuinely sufficient frequency to catch a real, developing issue promptly. — Testing frequency should genuinely reflect real risk, not a minimal, infrequent schedule.
- Temperature monitoring is documented but the response process for out-of-range readings isn't clearly defined. — Monitoring without a genuine, defined response doesn't provide real protective value on its own.
- Capacity is generally respected but isn't consistently enforced during the facility's busiest periods.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current thermal and mineral spring practice against updated safety regulation and best practice. |
| Week 2 | Establish or strengthen regular, sufficient water quality and temperature monitoring. |
| Week 3 | Build a genuine, enforced bather capacity limit, including during high demand. |
| Ongoing | Audit compliance against current, updated regulatory requirements. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Regulatory compliance review | Reviews evidence of genuine, current compliance with water quality and safety regulation. |
| DOCUMENT | Temperature monitoring review | Reviews records of active, regular temperature monitoring. |
| OBSERVE | Capacity enforcement observation | Observes whether bather capacity limits are genuinely enforced, particularly during high demand. |
Supervisor tips
- Ask to see the actual, current water quality testing records, not a general assurance of safety. — A real, specific record reveals genuine, current compliance, not assumed adequacy.
- Observe capacity enforcement during a genuinely busy period. — This is where capacity limits are most likely to be informally relaxed.
Evidence base
[42] Global Wellness Institute wellness policy specifically calls for updating regulations and following international best practices for regulating health and safety at thermal and mineral springs bathing establishments, reflecting genuine, documented gaps between historical practice and current safety standards.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.8
Travel Insurance and Emergency Evacuation Coverage Is Verified
Core
Before high-intensity or remote-location programming, the facility genuinely verifies that an international guest holds adequate travel insurance, including emergency medical evacuation coverage — not assuming guests have arranged this themselves without confirming it.
In plain terms: Before an international guest does anything high-intensity or in a remote location, the facility confirms they have travel insurance that covers it, including emergency evacuation.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
A guest injured on a mountain trek, or suffering a cardiac event at an altitude retreat, may need helicopter evacuation and repatriation — costing tens of thousands. Standard travel insurance often excludes 'adventure' activities and altitude. A guest without cover faces a catastrophic bill or, worse, delayed evacuation while payment is arranged. The facility verifies before the activity: the guest's policy, its activity coverage, its evacuation coverage. Guests without adequate cover are offered the option to obtain it or excluded from the activity.
What good looks like
- Insurance and evacuation coverage are genuinely, actively verified before intensive programming.
- Verification specifically confirms evacuation coverage, not general insurance alone.
- A real, defined response addresses an identified coverage gap.
Common failure modes
- Coverage is assumed without genuine verification.
- Verification, if any, confirms general insurance without specifically checking evacuation coverage.
- Programming proceeds regardless of an identified coverage gap.
Worked example
In practice
A wellness centre running high-altitude trekking retreats.
BeforeInsurance was 'the guest's responsibility.' A guest with altitude sickness needed helicopter evacuation; her travel insurance excluded activities above 3,000 metres; she faced a €25,000 bill and the evacuation was delayed by payment issues.
ActionInsurance verification was added to booking for high-intensity and remote programmes: the guest provides their policy; the facility checks activity and altitude coverage and evacuation cover; guests without adequate cover are directed to a specialist insurer; no participation without verified cover. An evacuation arrangement with a provider was contracted.
AfterThe Monitor reviewed 20 booking files with verified insurance and the evacuation contract. Verified.
If you are starting from zero — do this first
- List programmes that are high-intensity or remote.
- Require insurance verification before booking each.
- Check activity, altitude, and evacuation cover specifically.
- Direct uncovered guests to a specialist insurer.
The most common mistake: Assuming the guest's travel insurance covers trekking at 4,000 metres.
Self-assessment questions
1. Does the facility genuinely verify travel insurance and evacuation coverage before high-intensity or remote programming? — Real, active verification, not an assumption guests have arranged adequate coverage themselves.
Evidence: Insurance verification record
Evidence: Insurance verification record
2. Does verification specifically confirm emergency medical evacuation coverage, not general travel insurance alone? — Specific, genuine confirmation of evacuation coverage, not general insurance assumed to include it.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
3. Is there a specific process for what happens if a guest lacks adequate coverage, not simply proceeding regardless? — A real, defined response, not intensive programming proceeding despite an identified coverage gap.
Evidence: Coverage gap response process
Evidence: Coverage gap response process
Common reasons for a PARTIAL answer
- Verification happens for the most remote programming but not consistently for moderately remote locations. — Genuine remoteness, not a binary extreme/non-extreme distinction, should determine when verification matters.
- Coverage is confirmed to exist but the specific evacuation limits aren't checked against genuine program risk. — A policy's coverage limits should genuinely match the actual risk of the specific program a guest is undertaking.
- A response process exists for identified gaps but isn't consistently applied when a guest is eager to proceed.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current insurance verification practice for genuine, specific evacuation coverage confirmation. |
| Week 2 | Establish verification specifically before high-intensity or remote-location programming. |
| Week 3 | Build a defined, consistently applied response for identified coverage gaps. |
| Ongoing | Confirm coverage limits genuinely match actual program risk level. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Verification record review | Reviews evidence of genuine insurance and evacuation coverage verification before intensive programming. |
| DOCUMENT | Evacuation coverage specificity review | Reviews whether verification specifically confirms evacuation coverage, not general insurance alone. |
| DOCUMENT | Coverage gap response review | Reviews the defined response when a guest lacks adequate coverage. |
Supervisor tips
- Ask how the facility would specifically verify evacuation coverage for a real, upcoming guest. — A specific, confident answer reveals genuine practice, not an assumption of adequate coverage.
- Ask what happens if a guest arrives without adequate coverage for planned intensive programming. — A specific, defined answer reveals whether the response process genuinely holds under real pressure.
Evidence base
[43] Adequate travel insurance including emergency medical evacuation coverage is established as a genuine safety consideration for wellness tourism, particularly for programming in remote locations where local emergency care access may be limited.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.9
Substance-Related Wellness Practices Follow Genuine Safety Disclosure and Legal Compliance
Non-Negotiable
Any wellness practice involving substances with genuine physiological or psychoactive effect — including those marketed as natural or traditional — follows genuine safety disclosure and confirmed legal compliance in the jurisdiction where it occurs, not offered without the guest genuinely understanding real risk or legal status.
In plain terms: Any wellness practice using substances with real physiological or psychoactive effects — plant preparations, ceremonial substances, high-dose supplements — has honest safety disclosure, screening, and legal compliance.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Full | Full |
Why this matters
Ayahuasca, psilocybin, kambo, high-dose supplements, IV vitamin protocols — wellness tourism increasingly involves substances with genuine effects and genuine risks: cardiac interactions, psychiatric decompensation, drug interactions, and in many jurisdictions, illegality. A facility offering these must: know the legal status where it operates; disclose the real risks honestly (not 'natural and safe'); screen for contraindications (cardiac disease, psychiatric history, medications, pregnancy); have medical support available; and obtain specific informed consent. A facility that cannot meet these should not offer the practice.
What good looks like
- Genuine safety disclosure accompanies any substance-related wellness practice.
- Legal compliance is genuinely confirmed for the actual jurisdiction.
- Guests genuinely understand both risk and legal status before participating.
Common failure modes
- Disclosure is absent, with safety assumed from natural or traditional framing alone.
- Legal status is assumed, not genuinely confirmed.
- Guests participate without genuine understanding of risk or legality.
Worked example
In practice
A wellness centre offering plant-medicine ceremonies and IV vitamin protocols.
BeforeCeremonies were described as 'ancient healing.' No contraindication screening. A guest on an SSRI participated and developed serotonin syndrome. The legal status of the substance was unclear. IV protocols were administered by a non-clinician.
ActionLegal counsel confirmed the status of each substance; one practice was discontinued as unlawful. For permitted practices: honest written risk disclosure; a medical screening (cardiac, psychiatric, medications, pregnancy) by a physician; exclusion criteria applied; a clinician present; specific informed consent; emergency protocol. IV protocols moved to nurse administration under physician oversight with the same screening.
AfterThe Monitor reviewed the legal review, screening records, consent forms, and the clinician presence log. Verified.
If you are starting from zero — do this first
- List every practice involving a substance with physiological effect.
- Confirm the legal status of each with counsel.
- Write honest risk disclosure and medical screening for each.
- Require a clinician present.
The most common mistake: Calling a psychoactive substance 'natural' as if that made it safe.
Self-assessment questions
1. Does any substance-related wellness practice come with genuine safety disclosure, not assumed safe from natural framing? — Real disclosure of actual risk, not an assumption natural framing means no risk.
Evidence: Substance-related practice disclosure documentation
Evidence: Substance-related practice disclosure documentation
2. Is legal compliance in the actual jurisdiction genuinely confirmed, not assumed? — Real, confirmed legal status, not assumed from traditional use elsewhere.
Evidence: Legal compliance verification
Evidence: Legal compliance verification
3. Does the guest genuinely understand both risk and legal status before participating? — Real, demonstrated understanding, not participation offered without informed context.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
Common reasons for a PARTIAL answer
- Disclosure covers general risk but doesn't specifically address genuine interaction risk with medications or conditions. — Real, specific interaction risk deserves the same genuine disclosure as general practice risk.
- Legal compliance was confirmed at some point but hasn't been reconfirmed as regulation has changed. — Legal status can genuinely change, and confirmation should reflect current, not historical, regulation.
- Disclosure happens but isn't consistently verified as genuinely understood before participation.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current substance-related wellness practices for genuine safety disclosure and legal compliance. |
| Week 2 | Establish specific disclosure covering real physiological risk and interaction considerations. |
| Week 3 | Confirm current legal compliance for the actual jurisdiction. |
| Ongoing | Reconfirm legal compliance as regulation changes. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Disclosure documentation review | Reviews genuine safety disclosure provided for any substance-related wellness practice. |
| DOCUMENT | Legal compliance review | Reviews confirmed legal compliance verification for the actual jurisdiction. |
| ASK | Guest understanding interview | Asks a guest what they understand about the risk and legal status of a substance-related practice offered. |
Supervisor tips
- Ask a guest what they were told about the risk and legality of a specific substance-related practice. — A specific, real answer reveals genuine disclosure and understanding, not an assumption of safety.
- Ask how the facility confirmed the practice is genuinely legal in this specific jurisdiction. — A specific, confident answer reveals genuine verification, not assumed legality.
Evidence base
[44] Global Wellness Institute wellness policy specifically calls for educating wellness travelers on the regulatory and safety issues for substances with cognitive or psychoactive effect used in some wellness contexts, establishing genuine disclosure as necessary practice, distinct from assumed safety based on natural or traditional framing.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.
8.10
Facilitator Representations About Program Intensity Match Actual Reality
Non-Negotiable
What a booking facilitator represents about a program's actual physical intensity and demands genuinely matches the program guests actually experience — not marketed as gentler or less demanding than reality to secure a booking, leaving guests to discover the genuine intensity only on arrival.
In plain terms: What the booking agent says about how hard the programme is matches what the guest actually experiences — no 'gentle retreat' that turns out to be bootcamp, or vice versa.
| Facility category | Crisis | Transition | Small | Standard |
|---|---|---|---|---|
| Applicability | N/A | Full | Adapted | Full |
Why this matters
A guest who booked a 'gentle yoga retreat' and finds six hours of intense training daily is at physical risk and will leave angry. A guest who booked 'intensive transformation' and finds gentle stretching feels cheated. Mismatch between representation and reality is both a safety issue (the guest was not screened or prepared for what they will do) and a trust issue. The facility must define each programme's intensity clearly, communicate it to agents in writing, and check that agents represent it accurately — including asking guests on arrival what they were told.
What good looks like
- The facility specifically verifies facilitator intensity representations against actual reality.
- A real, active process identifies and corrects facilitator misrepresentation.
- Guests are specifically asked whether the program matched expectations.
Common failure modes
- Intensity representation accuracy isn't specifically checked, only general facilitator legitimacy.
- Misrepresentation patterns are tolerated without correction.
- Guests aren't asked whether their experience matched what they were told to expect.
Worked example
In practice
A wellness centre with programmes ranging from restorative to intensive.
BeforeAgents described programmes in their own words. A guest with a cardiac history booked a 'relaxation retreat' that was actually high-intensity; she had not been screened for that intensity. Another booked 'intensive' and got restorative. Arrival surveys showed 30% of guests had a different understanding than the programme's actual intensity.
ActionEach programme received a defined intensity rating (1–5) with a plain description of a typical day, hours of activity, and physical demands. Agents receive these in writing and must use them. Booking confirmations include the rating. Guests are asked on arrival what they were told; mismatches are logged and raised with the agent. Screening intensity matches the programme rating.
AfterThe Monitor reviewed the programme intensity descriptions, agent communications, and arrival surveys (mismatch down to 4%). Verified.
If you are starting from zero — do this first
- Rate each programme's intensity 1–5 with a description of a typical day.
- Send the ratings to every agent in writing.
- Put the rating on every booking confirmation.
- Ask guests on arrival what they were told.
The most common mistake: Letting agents describe intensity in their own words — 'transformative' means something different to everyone.
Self-assessment questions
1. Does the facility specifically verify that facilitator representations of program intensity match actual reality? — Real, specific verification of intensity representation, not general facilitator legitimacy checking alone.
Evidence: Intensity representation verification process
Evidence: Intensity representation verification process
2. Is there a specific process for identifying and correcting a facilitator who consistently misrepresents intensity? — A real, active process, not passive tolerance of a pattern of misrepresentation.
Evidence: Misrepresentation correction process
Evidence: Misrepresentation correction process
3. Are guests specifically asked, on arrival, whether the program matches what they were told to expect? — Real, direct verification from the guest's own perspective, not assumed accuracy.
Evidence: N/A — tested directly
Evidence: N/A — tested directly
Common reasons for a PARTIAL answer
- Verification happens for new facilitator relationships but isn't revisited if intensity representations drift over time. — A facilitator's representations can genuinely change, and verification should track this on an ongoing basis, not only at initial relationship setup.
- Guest feedback on expectation match is gathered but not systematically connected back to a specific facilitator. — Feedback that isn't traced to its source doesn't provide the genuine, actionable signal this criterion depends on.
- A correction process exists but hasn't been applied even when a real pattern was identified.
Implementation plan
| When | What |
|---|---|
| Week 1 | Review current facilitator oversight for genuine intensity representation verification. |
| Week 2 | Establish a process specifically checking representation accuracy against actual program reality. |
| Week 3 | Build a genuine correction process for identified misrepresentation patterns. |
| Ongoing | Gather and trace guest expectation-match feedback to specific facilitators. |
How the Monitor verifies this
| Method | What | Detail |
|---|---|---|
| DOCUMENT | Intensity verification process review | Reviews the specific process for verifying facilitator intensity representations against actual program reality. |
| DOCUMENT | Misrepresentation correction review | Reviews the process for identifying and correcting a facilitator with a pattern of misrepresentation. |
| ASK | Arrival expectation check | Asks a recent guest whether the actual program matched what their facilitator told them to expect. |
Supervisor tips
- Ask a recent guest directly whether the actual program matched what they were told to expect. — A real, direct answer reveals genuine accuracy, not assumed facilitator reliability.
- Ask for a real example of a facilitator being corrected for misrepresenting program intensity. — A real example, or its honest absence, reveals whether this process genuinely functions.
Evidence base
[45] Accurate representation of actual program intensity and content, verified against real guest experience, is established as a specific, necessary dimension of facilitator oversight in wellness and medical tourism governance, distinct from general facilitator legitimacy verification alone.
ASF training courses on GMJ Academy →
Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.