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IV Title
Blood Draw Title
IV or Blood Draw Selected
• • •
Medications Add Ons
• • •
Administered By
Bag Size
Payment
IV Placement
• • •
First Time IV
Complications
• • •
Successful Procedure
Program Number
Base Bag
Liquid Money
Additional Notes
Energy
NAD
Immunity
PostOp
Beauty
Detox
Relax
Blue IV
ALA Bag
B12 (methylcobalamin)
Custom Bag Ingredients
Oxytocin (10IU/ml)
Vitamin C (500mg/ml)
Carnitine (500mg/ml)
Glutathione (300mg/ml)
Glycine (100mg/ml)
Taurine (50mg/ml)
Arginine (500mg/ml)
Folic Acid (10mg/ml)
Ca Glucornate 10% (10mg/ml)
Mag Cl (200mg/ml)
Dexpanthenol (250mg/ml)
Pyridoxine (100mg/ml)
PC (50mg/ml)
Lidocaine 2% (ml)
DMSO 99.9% (ml)
Sodium Bicarbonate 8.4% (ml)
MSM (150mg/ml)
CA EDTA (300mg/ml)
CoQ10 (1.5 mg/ml)
Ribose - 5 - Phosphate (50mg/ml)
Glycyrrhic (8mg/ml)
D Ribose (15mg/ml)
Selenium (200mcg/ml)
Lipoic Acid (25mg/ml)
Thiamine (200mcg/ml)
NAC (100mg/ml)
Vitamin A (50,000U/ml)
Vitamin D3 (400,000IU/ml)
Thymus (5mg/ml)
Vitamin D3 (5000IU/ml)
Tryptophan (10mg/ml)
Glutathione (300mg/ml)
Taurine (50mg/ml)
Zinc Cl (10mg/ml)
Ornithine (100mg/ml)
NADH (100mg/ml)
Vitamin E (250IU/ml)
B Complex (1mg/ml)
Bag Thermic
Bag Libido
Base Bag Additions
Energy Shot
• • •
Repeat IV

IV or Blood Draw Visit Medical Form

General Practice

Yvelyn

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Published: Nov. 15, 2022, 6:51 p.m.
Doctor: Dr. History Physical
Rating: 0   /

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