IV VITAMIN THERAPY CLINIC PATIENT INTAKE FORM
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Medical History(Please check if you have had or have any of the following)

IV Vitamin Therapy Clinic Consent to Treatment

Intravenous (IV) therapy as used in this office is a means to deliver nutrient substances, and other medications, to your body while avoiding the digestive process. This is helpful in many cases where patients are depleted of certain nutrients, or when the substance can have more medicinal value through the IV route.

Most patients have no adverse effects on the type of IV therapy we offer.

Some common effects that may come and go but are generally safe MAY be:

•  A warm/tired or relaxed feeling from the minerals in the IV

•  Slight to moderate lightheadedness

•  Short term blood sugar changes

•  Discomfort at the IV site during or after the treatment

•  Thirst

•  Nausea

These effects are best dealt with as they arise, and we will give you specific instructions to help avoid or shorten them. It is your responsibility to inform us immediately if you feel any discomfort or sensation that is unusual.

 

Infiltration of the IV (the fluid leaking out of the vein and into the surrounding tissues) is an occasional occurrence in all IV therapy. It can cause pain, swelling, and bruising on occasion. This is rare in our office practice as the IV time is relatively short (as compared with IV duration in the hospital setting). If this occurs we will treat it as necessary. The effects of infiltration can be uncomfortable but do go away. If you notice pain, swelling or bruising around your IV site please let us know. Immediately apply ice as well.

 

Similarly to infiltration, the vein may become sore or slightly swollen or warm after an IV. This is typically irritating but not dangerous, and the vein may feel firm for one to five weeks.

 

Notify us of this immediately as well.

 

Although materials injected in this clinic are generally safe and well-tolerated by the body it is important for you to understand that all injections may cause very rare but potentially serious or even life-threatening reactions. We will and do take necessary precautions to avoid serious complications – but you need to know that they exist, however rare the risk may be.

 

I HAVE READ, UNDERSTAND, AND HAD ALL MY QUESTIONS ANSWERED ABOUT THIS PROCEDURE AND ITS RISKS AND BENEFITS TO ME.

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Clinic: 1-702-966-2440

3790 Paradise Rd. Suite140 Las Vegas, NV 89169

Located a block from the Las Vegas Strip behind the Wynn Hotel

 2015-2020 ©I.V Vitamin Therapy Clinic, All Rights Reserved  

The services provided have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. The material on this website is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any treatment program.