Health Form

Client Liability Waiver and IV consent:
 

I understand that peripheral vein catheterization and administration of IV fluids and related services involves certain risks, including but not limited to infection, allergic reactions, bruising, irritation, and pain. I acknowledge that I have been informed of the potential risks, and I assume full responsibility for any adverse effects that may result from the IV therapy.

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I certify that I have provided accurate and complete information regarding my medical history, medications, and allergies, and I understand that this information is necessary for the safe administration of IV therapy. I acknowledge that it is my responsibility to inform the nurse of any changes in my medical history, medications, or allergies.

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I acknowledge that the IV hydration business and its nurses are not liable for any injuries, damages, or other claims arising from my participation in IV therapy. I hereby release and discharge the IV hydration business and its nurses from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or any property belonging to me, whether caused by negligence or otherwise, while participating in IV therapy.

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I understand this procedure is not covered by a health insurance plan. I agree to pay the cost of the service. 

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I understand that Drips and its nurses may need to reschedule or cancel my appointment due to unforeseen circumstances, and I release them from any liability for such changes.
 

I have read this liability waiver and consent and fully understand its terms. I sign it freely and voluntarily, without inducement or duress, and intend for it to be a complete and unconditional release of all liability to the greatest extent allowed by law.
 

By signing, you confirm your agreement.