I certify that I am in good health and/or have my physician’s approval. I have read the above information about the B-Complex, B12 and MIC injection. I have had the opportunity to ask my personal healthcare provider questions that I may have had before receiving this injection. I understand the benefits and risks of this injection. I release the service provider and all Youthful Reflections medical providers, nurses, employees, owners, managers and directors, from any and all liability arising from or or in connection with this injection.
Vitamin B complex, B12 and MIC is safe and non-toxic even when taken in high doses; however, I understand that it is possible that I could have an adverse reaction, though rare, they can include: mild diarrhea, anxiety/panic attacks, heart palpitations, insomnia, breathing problems, chest pain, skin rashes/hives.
Most common side effects are redness/swelling and soreness around the injection site lasting up to a few days.
We do not offer Acute/Urgent Care Services nor do we offer Primary Care Provider Services. We strongly recommend all of our clients to form a relationship with a Primary Care Provider and have regular check-ups. If at any time you are faced with a medical emergency, please contact your Primary Care Provider, report to the nearest Emergency Department or Urgent Care Center, or Activate Emergency Medical Services by dialing 911.
Vitamin and nutritional supplements are not intended to diagnose, treat, cure or prevent and illness or disease.