lifecareforwomen.com - B12 Injection Consent Form

B12 Injection Consent Form
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Informed Consent for B12 Injection Treatment: l, (Patient's Name) , hereby give my informed consent to Linda I. Sodoma DO, PLC, and its medical staff to administer intramuscular B12 injections as deemed necessary or beneficial to my health and well-being.
I have been informed about the potential benefits and risks associated with B12 injections, which may include but are not limited to:
- Improvement of energy levels and cognitive function
- Possible side effects such as minor bruising and bleeding at the injection site, dizziness, headaches, and rare allergic reactions
I understand that B12 injections are generally considered safe and are often used to treat or prevent B12 deficiency, which can lead to various health issues.

I acknowledge that I have had the opportunity to ask questions regarding the treatment and that all my questions have been answered to my satisfaction.

By signing below, I agree to proceed with the B12 injection treatment and release Linda I. Sodoma DO, PLC, and its medical staff from any liability associated with this procedure.
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