WAIVER AND CONSENT FOR TREATMENT
Performance Recovery, LLC
I understand and acknowledge the risks and potential side effects associated with receiving IV infusion therapy from Performance Recovery. By signing this waiver, I voluntarily assume all risks and waive any claims against Performance Recovery, its owners, employees, agents, and affiliates for any injury, loss, damage, or expense that may occur during or as a result of the IV infusion therapy session.
I have been informed and understand that IV infusion therapy involves the insertion of a needle into a vein to administer various substances directly into my bloodstream. I acknowledge that potential risks and side effects of IV infusion therapy may include, but are not limited to:
Bruising, soreness, or irritation at the infusion site.
Infection at the infusion site.
Allergic reactions or adverse effects related to the administered substances.
Vein inflammation or phlebitis.
Infiltration of fluids into surrounding tissues.
Blood clots or deep vein thrombosis (DVT).
Nerve damage or injury.
Fluid overload or electrolyte imbalances.
I understand that while Performance Recovery takes all necessary precautions to minimize these risks, complications may still occur. I acknowledge that it is my responsibility to disclose any medical conditions, allergies, medications, or previous adverse reactions that could affect my suitability for IV infusion therapy. I further understand that it is my responsibility to inform the healthcare provider promptly of any changes to my health status during my infusion.
I hereby release, discharge, and hold harmless Performance Recovery, its owners, employees, agents, and affiliates from any and all liability, claims, demands, actions, or causes of action arising out of or in connection with the IV infusion therapy, leg compression, percussive therapy, and nutritional supplementation provided by Performance Recovery. This waiver includes but is not limited to, claims for personal injury, property damage, medical expenses, lost wages, or any other damages. I grant Performance Recovery permission to use my image, including photographs, videos, or any other visual representation, for marketing and promotional purposes.
I certify that I am over the age of 18 and that I have carefully read and understand the contents of this waiver. I acknowledge that I am signing this waiver voluntarily and of my own free will, without any coercion or undue influence. I agree that this waiver shall be binding upon my heirs, personal representatives, and assigns.