Informed Consent For Intravenous (IV) Therapy I hereby give my informed consent for the intravenous administration, vitamin therapy, vitals, basic health risk assessments (prior to any service), and/or other related health services (not including medicine or any medical treatment), (collectively referred to as \”IV\r\nTherapy\”) as set forth.\r\n\r\nI understand that this Document is intended to serve as confirmation of informed consent for IV Therapy as ordered by a licensed physician and by IVMENOW.\r\n\r\nI acknowledge that I have completed the medical consent form. Prior to the service, I have/will inform the technician of any and all known allergies to the\r\ndrugs or other substances that may be included in the ingredients of my solutions, or of any past reactions to anesthetics.\r\n\r\nI acknowledge that the Registered Nurse is using all new and clean, including needles, etc., and that I will watch the technician remove said items from their new and clean packaging. I acknowledge that I am not now impaired and/or under the influence of illegal drugs and/or alcohol.\r\n\r\nI acknowledge that during the procedure I will not be impaired by and/or be under the influence of any alcohol and/or illegal drugs and will confirm same with the Registered Nurse upon their arrival. Medical information, personal information, and history divulged during my IV Therapy will be kept strictly confidential unless I consent to sharing my information by way of a signed release. I understand that I have the right to be informed during the procedure, and the risks and benefits. except in emergencies. Procedures are not performed until I have had the opportunity to receive such information and have given my informed consent by executing this document. The IV Therapy intravenous procedure involves inserting a needle into your vein and infusing over a determined period of time, prescribed nutrients (vitamin, minerals, and amino acids).\r\n\r\nI understand that risks, benefits and alternatives to IV’s may include but are not limited to:\r\n1) The Risks and potential side effects?a) Discomfort, bruising, and pain at the site of injection\r\nb) Inflammation of the vein used for injection, phlebitis, metabolic disturbances, and injury.\r\nc) Severe reaction, anaphylaxis, cardiac arrest, or death.\r\n2) The Benefits\r\na) Injectables are not affected by stomach or intestinal disease.\r\nb) Total amount of infusions enters the bloodstream and is available to the tissues.\r\nc) Intravenous hydration allows for an increased absorption of vitamins that cannot always\r\nbe achieved by oral supplementation. Intravenous therapy avoids the vitamin being\r\nbroken down in the stomach, which can help avoid irritation to the gastro intestinal tract.\r\n3) Alternatives to intravenous vitamin therapy are oral supplementation and/or dietary and lifestyle changes.\r\n\r\nI understand that IV Therapy is not a substitute for medicine, medical treatment, or the diagnosis, treatment, or cause of disease by a medical provider. I am aware that other unforeseeable complications could occur. I understand the risks and benefits of the IV Therapy and will have the opportunity to have all my questions answered.\r\n\r\nI understand that all sales are final once the iv process has started.\r\n\r\nCANCELLATION POLICY\r\nRegistration cancellations 7 or more days from start of a service/appointment will receive a 100% refund, minus $10 processing fee per scheduled guests, clients, and customers.\r\nRegistration cancellations less than 7 days and more than 48 hours from start of a service/appointment will receive a 100% refund, minus a $25 administrative fee per scheduled guests, clients, and customers.\r\nNo refunds will be issued for cancellations 48 hours or less prior to the service/appointment. However, such guests, clients, and customers may attend a future service/appointment by paying a $35 rescheduling fee.\r\nOnce the service/appointment has begun or been rescheduled, no refunds will be given unless otherwise stated or agreed upon.\r\nWe reserve the right to cancel or reschedule a service/appointment due to the lack of participation or personnel/workplace emergency situations. Please be advised that notification of canceled or rescheduled service/appointment (s) will be given by phone or email as soon as possible.\r\n\r\n\”NO SHOW\” POLICY\r\nNo refunds will be issued for a \”No Show\” on the day of service/appointment for guests, clients, and customer who have already paid their service/appointment (s). This includes any guests, clients, and customers who does not contact us by phone or email to cancel their service/appointment(s). If a guest, client, and customer has not paid for their service/appointment(s), then a $25 “Now Show” fee is charged. However, such guests, clients, and customer may attend a future scheduled appointment by paying a $35 rescheduling fee.\r\nPlease refer to our Cancellation Policy stated above.