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IV Infusion Consent Form

IV Infusion Consent Form 2025

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The document is an informed consent form for Intravenous (IV) Infusion Therapy at Wellness Medical Center, authored by Dr. Olena Gordon. It outlines the procedure's purpose, potential benefits, risks, and alternatives, emphasizing that the therapy is not FDA evaluated and may be considered medically unnecessary. The patient acknowledges understanding the information provided, consents to the treatment, and accepts financial responsibility for non-covered services.

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