• Patient Information

    This intake form will give our doctor all the information needed to approve your shot before you even walk through the door!

  • Informed Consent for Treatment:

    I have been informed about my chosen product, and understand the information regarding the risks and benefits of vitamins and amino acid injectables. I have had a chance to ask questions on treatment. I understand the possible complications of injection into the muscle; which are bruising at the site, numbness and tingling, dizziness, headaches, and possible fainting from the sight of blood. I understand that there may be a slight chance for sensitivities and reactions to any injectable solutions. I understand that I do not have an allergy to niacin. I understand that there may be numbness in the muscle that is injected for a period of time. I hereby release The B-12 Store and all it's employees from all liabilities regarding my treatment with vitamin and amino acid injectables.

  • Book Appointment

    This final step will allow you to book your appointment at the location of your choice. We will send a confirmation to the email address you provided.
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