Medical Intake Form

IV hydration therapy involves the intravenous administration of fluids, electrolytes, vitamins, and/or medications to rapidly restore hydration, replenish essential nutrients, support immune function, boost energy, relieve symptoms, and promote overall wellness. By delivering 100% absorption directly into the bloodstream—far more effective than oral supplements—this treatment provides fast relief from dehydration, fatigue, hangover symptoms, jet lag, migraines, muscle soreness, or chronic conditions, while also enhancing athletic recovery, strengthening immunity, improving skin clarity, and supporting cellular repair and anti-aging through premium infusions like Myers Cocktail, NAD+ Cellular Recharge, and Glutathione. Your customized blend is carefully selected based on your health goals and medical screening to help you Recharge, Recover, and Rehydrate safely and efficiently.

IV hydration therapy is generally safe when administered by a licensed registered nurse. However, as with any medical procedure, possible side effects may include:Pain, redness, swelling, or bruising at the IV insertion siteVein irritation or phlebitis (inflammation of the vein)Infection (rare, prevented with sterile technique)Allergic reaction to fluids, vitamins, or additivesDizziness, lightheadedness, or fainting (especially if standing quickly)Nausea, headache, or flushing during infusionElectrolyte imbalance or fluid overload (extremely rare with proper screening)Air embolism or blood clot (very rare with standard protocols)Our team follows strict medical guidelines to minimize risks. You will be monitored throughout your session, and treatment can be stopped at any time.

I acknowledge that I have provided a complete and accurate medical history, including all known conditions, medications, allergies, and prior reactions to IV therapy. I understand the purpose, benefits, and potential risks of IV hydration therapy as explained above. I voluntarily consent to receive IV therapy from IV League Hydration. I release IV League Hydration, its nurses, staff, and affiliates from any liability related to treatment outcomes, except in cases of gross negligence or misconduct. I understand I may refuse or stop treatment at any time without penalty.

I authorize IV League Hydration to take photographs or video of me during my session for use in marketing, social media, website, or educational materials. I understand these images may be shared publicly and will not include my name or protected health information unless separately authorized. I will not receive compensation for their use.

Skip to the bottom and submit your intake form.