Get Iv Therapy Intake Form

Completing the Iv Therapy Intake Form online is a straightforward process designed to gather essential information for your nutritional IV therapy. This guide will walk you through each section of the form to ensure you provide all necessary details accurately and completely.

Follow the steps to successfully complete the Iv Therapy Intake Form.

1. Click the ‘Get Form’ button to access the Iv Therapy Intake Form. This will allow you to open the document online and begin entering your information.
2. Fill in the general information section, including today's date, how you heard about the service, and your personal details such as first name, last name, date of birth, age, gender, address, and contact information.
3. Indicate your health goals with nutritional IV therapy. You may list up to two specific goals in the provided fields.
4. In the general health section, answer questions about whether you are currently seeing a physician, any existing health problems, allergies, smoking, alcohol consumption, dietary habits, exercise, and hydration. Provide explanations where necessary.
5. Complete the medical history section by marking any illnesses or conditions you currently have or have had in the past by checking the appropriate boxes.
6. List all current medications and supplements in the medications and supplements section, including dosages and any past therapies, if applicable.
7. In the diagnostic studies section, provide details of any diagnostic tests you have undergone, along with corresponding dates and results.
8. Review your symptoms using the symptom review section, indicating any currently experienced or recent symptoms across various categories, using the provided scale for severity.
9. Complete the environmental/detoxification history, nutrition, and acknowledgements and consent sections. Be sure to read the consent statements and initialize accordingly.
10. Finally, thoroughly review all your entries for accuracy. Once verified, you can save changes, download, print, or share the completed Iv Therapy Intake Form.

Start filling out the Iv Therapy Intake Form online today for a personalized health experience.