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Ready to boost your health with our premium IV therapies? We're here to answer your questions and get you scheduled for your next energizing session.

Head Office

100 Crescent Court, Dallas, Texas, 75201

Email Support

[email protected]

Let's Talk

Phone : 817-917-4043

Service Hours

24/7 After hours fees will apply

Good Faith Exam $20.00 Annually One Time
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Patient's information

Name
Name
First Name
Last Name

Emergency Contact

Emergency Contact Name
Emergency Contact Name
First Name
Last Name

Medical History

Check the symptoms that you' re currently experiencing:
Are you currently taking any medications?
Do you have any known medical allergies?
Are you currently under medical treatment?
Do you take any medicine(s) for fluid retention (i.e. diuretic)?
Do you have any impairment preventing you from making medical decisions and/or consenting to your treatment?
Please list all of your current non-prescription, over-the-counter medicines, and/or supplements?
Do you have a history of or any current build up of fluid in your extremities (edema)?

Family History

Check the conditions that apply to you or any member of your immediate family:
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