Informed Consent for Treatment
By signing below, I confirm that I understand the risks, benefits, and alternatives of my selected treatment(s) and have had the opportunity to ask questions. I acknowledge that the services provided, including but not limited to consultations, wellness treatments, and any information shared during my visit, are for general wellness purposes only. I understand that these services do not consitute medical advice, diagnosis, or treatment.
Potential Risks & Complications IM & IV Therapy Risks:
- Injection site reactions: redness, swelling, bruising, numbness, tingling.
- Risk of fainting, dizziness, headaches.
- Pain, irritation, or nerve damage at the injection site.
- Infection risk, even with sterile technique. I understand I must follow post-care instructions.
- IV risks: Extravasation (fluid leakage), Thrombophlebitis (vein inflammation), vein irritation, and potential scarring.
- Air embolism risk (rare but serious) if air enters the IV line.
- Electrolyte imbalances or fluid overload, particularly in patients with kidney, heart, or liver conditions.
- Patients with a history of blood clots (DVT/PE) should consult their doctor before treatment.
Weight Loss Medications:
- Nausea, headaches, fatigue, constipation, diarrhea.
- Vomiting, bloating, abdominal pain, acid reflux (GERD), and dehydration.
- Hypoglycemia risk if combined with insulin or other glucose-lowering medications.
- Pancreatitis risk (severe abdominal pain, nausea, vomiting).
- Gallbladder issues, including gallstones (common with rapid weight loss).
- Muscle loss and nutritional deficiencies if not monitored properly.
- Delayed gastric emptying affecting oral medication absorption.
- Compounded semaglutide/tirzepatide are not FDA-approved and may vary in potency and effectiveness.
Medication Disclosure & Acknowledgment
I understand that the GLP-1 medications offered at this facility (including semaglutide or tirzepatide) are compounded formulations. These medications are not FDA-approved, as compounded drugs are custom-made by licensed pharmacies and are not reviewed by the U.S. Food and Drug Administration for safety, effectiveness, or quality. I acknowledge that potency and effectiveness may vary compared to commercially available, FDA-approved products such as Wegovy®, Ozempic®, or Mounjaro®. I consent to receive these compounded medications with this understanding.
Latisse & Medical Skincare Risks:
- Eye irritation, redness, permanent iris darkening (Latisse).
- Medical Skincare Risks: Dryness, peeling, burning sensation, breakouts, allergic reactions, increased sun sensitivity (sunscreen is required).
- Improper use or combining with other products may cause chemical burns, pigmentation changes, or prolonged irritation.
Patient Responsibilities & Acknowledgment
✅ I disclose all medical history, allergies, and medications that may impact treatment.
✅I acknowledge the potential risk of infection and agree to follow post-care instructions.
✅ I accept full responsibility for any complications.
✅ I understand results vary and are not guaranteed.
✅ In case of a medical emergency, severe reaction, or concerning symptoms, I will seek immediate medical attention or visit the nearest hospital.
Release of Liability
- I voluntarily assume all risks and release Vydration, its employees, and providers from any liability, including infections or adverse reactions, unless caused by proven gross negligence.
- I understand that Vydration is not an emergency medical facility and does not provide urgent or emergency care.
- If I experience a severe reaction, I will seek immediate medical attention at a hospital or with a licensed provider.
- I acknowledge that individual results vary, and no guarantees have been made regarding the effectiveness of treatments.
- I waive my right to pursue legal claims related to dissatisfaction with results, minor side effects, or known risks, except in cases of willful misconduct.
- I understand that I am financially responsible for all treatments received and agree to hold Vydration harmless from any financial disputes, including those related to third-party payments, insurance coverage, or chargebacks.
Non-Refundable Policy & Shipping Disclaimer
All sales are final. No refunds.Treatments may be transferred to another individual upon approval. Shipping Clause: I acknowledge that any products or medications shipped to me are carefully packed and documented. In the event of a claim of missing, damaged, or incorrect items, I understand that an internal investigation will be conducted. False claims of non-receipt or missing items may result in denial of replacement, refusal of future service, and potential legal action.