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Patient Portal

Your care

Complete your intake and consent once, and it is on file for every visit. Everything here is private to you.

Please sign in

Your medical information is private, so we need to know it is you. Signing in takes a moment and keeps your records safe.

Before your first drip

Intake and consent

This is the same information we would take on paper. It is reviewed by our clinician before any treatment.

Your details

In case of emergency

Medical history

Please tick everything that applies. If none apply, tick "None of the above".

G6PD deficiency means high-dose Vitamin C and our Immunity infusion are not suitable for you. Our clinician will review this with you and recommend a safe alternative before any treatment. Please bring your lab result if you have one.

What brings you in

Tick everything that applies.

Privacy notice

This notice describes how your medical information may be used and disclosed, and how you can get access to it. Please review it carefully before signing.

Your rights. You may request a copy of your medical record and ask for corrections. You may request confidential communications and place restrictions on certain uses of your information. You may get a list of those with whom your health information has been shared. You may make a complaint if you believe your rights have been violated. You will be notified promptly following a breach of your unsecured health information. You may receive a paper copy of this notice on request.

How we use it. We may use or share your health information for treatment, billing and operational purposes, and as required by law. We will not sell or share your information for marketing purposes without your explicit written authorisation.

Informed consent for IV therapy

1. Nature of the procedure. IV therapy involves inserting a small catheter into a vein, typically in the hand or forearm, through which fluids, vitamins, minerals, electrolytes, amino acids and other compounded substances are administered directly into the bloodstream, bypassing the digestive system.

2. Potential benefits. Rapid restoration of fluid and electrolyte balance, enhanced delivery of vitamins and minerals with immediate cellular uptake, accelerated recovery from illness, dehydration or physical exertion, support for immune function and energy production, and improved absorption compared with oral supplementation.

3. Known risks and complications. I understand IV therapy carries these potential risks, which have been explained to me: infiltration, phlebitis, haematoma, infection or sepsis, extravasation, air embolism, allergic or anaphylactic reaction, fluid overload, and nerve injury.

4. Compounded substances. Some substances administered during IV therapy, including compounded vitamins, minerals, amino acids, NAD+ and glutathione preparations, have not been individually approved by a drug regulator for intravenous use in elective wellness settings. I understand and accept this disclosure.

5. Pregnancy and contraindications. Certain formulations, including high-dose Vitamin C, chelating agents and some compounded preparations, are contraindicated during pregnancy and breastfeeding. By signing, I confirm that I am not currently pregnant or breastfeeding, or that I have disclosed my status and my supervising provider has reviewed and approved the specific formulation.

6. Alternatives. I understand that alternatives include oral supplementation, intramuscular injection, dietary modification and standard medical care. These have been discussed with me or are available on request.

7. Right to refuse or withdraw. I have the absolute right to refuse IV therapy or to withdraw consent at any time during the infusion, without penalty or prejudice to my future care. I may request immediate cessation of the infusion at any time.

8. Patient declaration. By signing below I confirm that I have read and fully understand this consent; that my questions have been answered to my satisfaction; that I voluntarily consent to receive IV therapy as ordered; and that I have accurately disclosed all relevant medical history, medications and allergies.

Your information is private to you and reviewed only by our clinical team. IV therapy is not intended to diagnose, treat, cure or prevent disease.

Welcome back

Your intake and consent are on file. There is nothing to fill in before your next visit.

On file

Completed

Your intake, privacy acknowledgement and informed consent are recorded.

A note on your treatments

You have told us you have G6PD deficiency. Our Immunity IV and Glow IV are not suitable for you, and our clinician will recommend a safe alternative.

Book a drip

Your details are already with us, so booking takes moments.

Your visits

Your paperwork

Your intake and consent are recorded and shared with our clinical team ahead of your visit.

Your credit

$0

Applied automatically at your next booking.

Something not right? Message us on WhatsApp and we will sort it.

Thank you

Your intake and consent are on file. Our clinician will review them before your treatment.