Mobile IV Therapy 2U SPA Event Booking Form

  • Mobile IV Therapy 2U Event Booking Form

    Complete this form to reserve your IV appointment. LIMITED SLOTS! 10 slots per hour

  • Client Information

  • Date of Birth*
     - -
  • Format: (000) 000-0000.

  • Service Selection

  • Which service would you like?*

  • Time Selection

  • Preferred Appointment Time*
  • Add-Ons (Optional)

  • Medical History

  • Do you have a history of any of the following?*
  • Are you currently pregnant or breastfeeding?*
  • Have you had IV therapy before?

  • Screening

  • Do you have any of the following?*

  • Deposit Payment

  • My Products

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      IV Therapy Appointment Deposit

      Non-refundable deposit to reserve your event booking. Remaining balance due at appointment.

      $100.00
        
      Total
      $0.00
      Credit Card Details

    • MOBILE IV THERAPY 2U LLC CONSENT
      CONCIERGE IV THERAPY INFORMED CONSENT & SERVICE AGREEMENT

      This agreement is entered into between the CLIENT and Mobile IV Therapy 2U LLC for elective concierge IV hydration and wellness services.

      Nature of Services
      Mobile IV Therapy 2U LLC provides elective wellness services, including IV hydration, vitamin therapy, and intramuscular (IM) injections. These services are not intended to diagnose, treat, cure, or prevent any disease and do not replace medical care from a licensed healthcare provider.

      Medical Responsibility
      The CLIENT is responsible for consulting their physician or healthcare provider regarding any medical conditions, diagnoses, or suitability for treatment. The CLIENT agrees to fully disclose all medical history, medications, and allergies. Failure to provide accurate and complete information may increase the risk of complications, including serious injury or death.

      Medical Oversight
      All services are provided by trained medical professionals operating under the supervision of a Medical Director and established protocols. Eligibility for treatment is determined at the time of service.

      Risks & Voluntary Consent
      The CLIENT understands that IV therapy and IM injections carry potential risks, including but not limited to allergic reactions, infection, vein irritation, fluid overload, electrolyte imbalance, and in rare cases, serious complications such as anaphylaxis, cardiac events, or death. The CLIENT acknowledges these risks and elects to proceed voluntarily.

      No Guarantee of Results
      Results vary by individual. No guarantees or warranties are made regarding outcomes or symptom improvement.

      Add-On Services & Payment
      Additional vitamins or medications added to IV therapy are $40 per dose. IM injections are $40–$60 depending on dosage. Additional IV fluids are available upon request.
      All add-on services are provided only at the CLIENT’s request and with Medical Director approval.

      The CLIENT accepts full financial responsibility for all services rendered. Payment is due at the time of service. All services are non-refundable once initiated.

      Release of Liability
      The CLIENT agrees to hold harmless Mobile IV Therapy 2U LLC, its owners, providers, affiliates, and partnering pharmacies from any adverse outcomes arising from voluntary participation, undisclosed medical conditions, or outcomes not resulting from gross negligence.

      Client Responsibilities
      The CLIENT agrees to immediately notify the provider of any discomfort during treatment and to report any concerns within 72 hours following the appointment.

      Acknowledgment & Consent
      By signing below, the CLIENT confirms that:

      They have read and understand this agreement
      All questions have been answered
      They have the right to refuse treatment
      They voluntarily consent to IV therapy, IM injections, and related services
      They accept all associated risks and financial responsibility

      I have disclosed my full medical history

      I understand results are not guaranteed

    • Informed Consent

    • Should be Empty: