Consent

Fill this out prior to your IV Infusion.

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IV infusion therapy involves administering vitamins, nutrients, and hydration directly into your bloodstream. This method bypasses the digestive system, allowing for faster absorption and immediate effects.

Potential Benefits:

  • Improved hydration

  • Enhanced energy and focus

  • Support for anti-aging and overall wellness

  • Boosted immunity and recovery

Potential Risks:

While IV therapy is generally safe when administered by a licensed professional, it may carry some risks, including:

  1. Minor pain, bruising, or redness at the injection site.

  2. Swelling, irritation, or vein inflammation (phlebitis).

  3. Infection at the injection site.

  4. Allergic reaction to any component of the infusion.

  5. Dizziness, fainting, or nausea.

  6. Fluid overload, especially for individuals with heart or kidney conditions.

  7. Electrolyte imbalance if improperly administered.

  8. Rare but serious complications, such as air embolism or blood clot.

Client Responsibilities:

  • Disclose accurate and complete medical history.

  • Inform staff of any medications or supplements you are taking.

  • Notify staff immediately of any discomfort during the procedure.

Acknowledgment and Consent:

By signing below, I acknowledge that I have:

  1. Fully disclosed my medical history and current health status.

  2. Read and understood the benefits, risks, and potential complications of IV infusion therapy.

  3. Been informed that IV infusion therapy is not a substitute for professional medical care and is not intended to diagnose, treat, cure, or prevent any disease.

  4. Had the opportunity to ask questions, and all of my questions have been answered to my satisfaction.

  5. Agreed to proceed with the treatment voluntarily and without coercion.

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