As Nutri-Drips are a medical procedure, albeit a minimally invasive one, we make sure all future and current clients are aware of the potential risks.  Please read and acknowledge the below statements: 

All medical activities are conducted and overseen by Dr. Maurice Beer and medical professionals employed by the Professional medical practice Beer and Sons PLLC. 

 

INFORMED CONSENT,
CLIENT REPRESENTATIONS/WARRANTIES
& DISCLAIMER AGREEMENT

 

PARTICIPANT RISK:

I understand that participating in intravenous (IV) hydration, vitamin/supplement administration, pharmaceutical administration, programs and services made available by Beer and Sons PLLC carries risks.

I ACKNOWLEDGE AND AGREE THAT THE SOLE RISK OF INJURY OR HARM RESULTING IN ANY MANNER FROM MY CHOOSING TO PARTICIPATE IN SUCH REGIMEN, PROGRAMS AND SERVICES RESTS ENTIRELY WITH ME TO THE EXTENT THAT I DO NOT DISCLOSE MY HEALTH CONDITIONS, MEDICATIONS OR DRUG USE IN ADVANCE.

I expressly represent and warrant to Beer and Sons PLLC that I have never been diagnosed with nor treated for any diseases, illnesses or conditions which may result in increased risk when I participate in regimens, programs or services made available by Beer and Sons PLLCand I am not choosing to participate with any expectation that Beer and Sons PLLC will screen for, diagnose, monitor or otherwise provide any care or treatment for such conditions

I acknowledge and understand that Beer and Sons PLLC is relying upon the foregoing representations and warranties from me upon Beer and Sons PLLC’s acceptance of me for participation in its IV hydration, programs and services.

RISKS INCLUDE THE FOLLOWING:

INJURY, BLEEDING, INFECTION, INFLAMMATION/SWELLING, BRUISING OR SCARRING RESULTING FROM IV INFILTRATION, EXTRACTION AND EXTRAVASATION

MISPLACEMENT OF IV LINES IN THE BODY

AIR EMBOLISM

FLUID OVERLOAD

MEDICATION ADVERSE INTERACTIONS

NERVE INJURIES

LIGHTHEADEDNESS OR FAINTING

 

ACKNOWLEDGMENT: I confirm that I have read this form and fully understand its contents. I acknowledge that no guarantees or assurances have been made to me concerning the results intended from the sessions and programs offered by Beer and Sons PLLC.  I understand the nature of the sessions and programs and that participating in them carries risks. I have been given an opportunity to ask questions, and all of my questions have been answered fully and to my satisfaction. I agree to my assumption of all risks associated with my participation.