LIPOTROPIC INJECTION INFORMATION

Lipotropic nutrients are a class of natural ingredients that play important role in the body's use of fat. These compounds enhance liver and gallbladder's role by decreasing fat deposits and speeding up

metabolism of fat and its removal.

Our formula of Lipotropics has been formulated to enhance your current weight loss efforts i.e. following healthy diet plan, staying well hydrated, and exercising. The amino acids/vitamins used to make these shots are: B1,B2, B6, B12, MIC, and L-CARNITINE.

Methionine (M) - an amino acid; acts to prevent excess fat build-up in the liver and the body. Is helpful in relieving or preventing fatigue and may have action in the anti-inflammatory process by reducing

Inositol (I) - a nutrient belonging to the B vitamin complex; closely associated with choline. It aids in the metabolism of fats and helps reduce blood cholesterol. Inositol participates in the action of serotonin, a neurotransmitter known to control mood and appetite.

Choline (C) - supports the health of the liver by processing and excreting chemical waste products within the body. In addition, it facilitates fat absorption by the cells. It is essential for the health of kidneys and

B12 - an essential vitamin that helps form new healthy cells in the body. It acts as an energy booster, helping increase activity level, improve sleep patterns, and provide relief from allergies and stress.

L- Carnitine - an amino acid that is naturally produced in the body as a primary building block for protein. It helps your body to produce energy, carries fat into cells so it can be burned as fuel, and assists in the reduction of belly fat.

LIPOTROPIC INJECTION CONSENT FORM

Each patient responds differently to medicine and may respond differently from one treatment to the next. As with all medicines, either oral or injectable, results are temporary and regular dosing is necessary. The length of time the injectable medication lasts varies in each patient. NO guarantee can be made in regard to the results and length of time it lasts. Weight loss can be inconsistent from one

As with any treatment there can be some risk. The following is the list of possible risk with injections: Pain or bruising, redness, bleeding at the injection site (these are usually minimal and dissipate in minimal amount of time Some people may experience allergic reaction to the injections. Stomach upset and urinary problems (urge incontinence), diarrhea. It has been reported that B12 can cause peripheral vascular thrombosis, itching. Some patients have reported experiencing joint pain.

B12 is contraindicated in Leber's hereditary optic neuritis, as it can cause blindness.

Please let us know if you have any of the following:

Liver disease, infection, Iron deficiency, Folic acid deficiency. Kidney disease Receiving any treatment that has an effect on bone marrow Taking any medication that has an effect on bone marrow An allergy to cobalt or any other medication, vitamin, dye, food or preservative

I had been given the opportunity to have all of my questions answered.

I will inform my practitioner of any changes in my medical history, current medications, and/or any changes relevant to this procedure prior any further treatments.

I have read and understand the ingredients of the injections being administered to me and I consent to treatment. I further acknowledge that I am taking this injection(s) of my own accord. I agree to release the facility and the medical practitioner from any liability arising from the procedure.

 

**Take Home Only** 

I agree to follow the instruction discussed with provider as well as instructions on Lipo Mino Take home package. I will not share this vitamin with others. I will properly dispose of needles in the sharps container provided. All of my questions have been answered in regard to self adminstration.