This disclosure explains services provided by Salt Hydration & Wellness subject to an Informed Consent, Release, and Waiver Agreement. By accepting such services, you acknowledge informed consent as to the following:
IV Therapy & Injection
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving point of care intravenous (IV) therapy treatment. Please read this section carefully and discuss any questions or concerns with your healthcare provider before proceeding.
Procedure: IV therapy treatment involves the administration of vitamins and nutrients directly into your bloodstream through an intravenous catheter. This method allows for rapid absorption and immediate availability of nutrients to your body.
Potential Benefits:
- Improved hydration
- Enhanced nutrient absorption
- Increased energy levels
- Boosted immune system
- Relief from symptoms of fatigue, stress, and hangovers
Potential Risks and Side Effects: While IV vitamin therapy and injections are generally safe, they do carry potential risks and side effects, including but not limited to:
- Infection: There is a risk of infection at the site of the IV or injection.
- Bruising and Swelling: Some patients may experience bruising, swelling, or pain at the injection or IV site.
- Phlebitis: Inflammation of the vein used for the IV can occur.
- Allergic Reactions: There is a risk of allergic reactions to the vitamins or materials used in the IV or injection.
- Electrolyte Imbalance: Incorrect administration of certain vitamins can lead to an imbalance in electrolytes.
- Kidney Stress: High doses of certain vitamins may place stress on the kidneys.
- Fluid Overload: There is a risk of receiving too much fluid, which can strain the heart and lungs, especially in patients with underlying health conditions.
- Blood Clots: Formation of blood clots in the vein used for the IV.
- Dizziness and Fainting: Some individuals may feel lightheaded, dizzy, or faint during or after the treatment.
- Hypersensitivity Reactions: Reactions such as itching, rash, or more severe anaphylactic reactions.
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Current Medications: Provide a list of all medications you are currently taking to avoid potential interactions.
- Hydration Status: Stay hydrated before the treatment to facilitate the IV process and reduce the risk of complications.
- Site Care: Follow all post-procedure care instructions to minimize the risk of infection and other complications.
Lab Draw or phlebotomy services
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving point of care phlebotomy services. Please read this section carefully and discuss any questions or concerns with your healthcare provider before proceeding.
Procedure: A point of care lab draw involves the collection of a blood sample from your vein by a trained healthcare professional. This sample may be sent to a laboratory for testing as ordered by your healthcare provider OR processed on site, creating serum tears in the treatment of dry eyes (see below).
Potential Benefits:
- Convenience of having the procedure performed at home
- Avoidance of travel and wait times at a clinic or hospital
- Reduced exposure to potential pathogens in healthcare settings
- Creation of serum tears for the treatment of dry eyes as requested by a licensed professional.
Potential Risks and Side Effects: While phlebotomy services are generally safe, they do carry potential risks and side effects, including but not limited to:
- Infection: There is a risk of infection at the site of the blood draw.
- Bruising and Hematoma: Some patients may experience bruising or the formation of a hematoma (a localized collection of blood) at the puncture site.
- Bleeding: There may be prolonged bleeding from the puncture site, especially in individuals with bleeding disorders or those taking blood-thinning medications.
- Fainting or Dizziness: Some individuals may feel faint or dizzy during or after the blood draw.
- Pain or Discomfort: Mild pain or discomfort may occur during and after the procedure.
- Nerve Injury: There is a rare risk of nerve injury at the puncture site.
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Hydration Status: Staying hydrated before the procedure can facilitate the blood draw and reduce the risk of complications.
- Site Care: Follow all post-procedure care instructions to minimize the risk of infection and other complications.
Aesthetic Injections and Consultations
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving Botox and other aesthetic injections in your home. Please read this section carefully and discuss any questions or concerns with your healthcare provider before proceeding.
Procedure: Aesthetic treatments involve the administration of Botox or other neurotoxin injectables to reduce the appearance of wrinkles, fine lines, and other facial imperfections. These treatments are performed by a licensed and trained healthcare professional.
Potential Benefits:
- Reduction of facial wrinkles and fine lines
- Improved facial contour and volume
- Enhanced overall appearance
- Convenience of receiving treatments in the comfort of your home
Potential Risks and Side Effects: While Botox and other aesthetic injections are generally safe, they do carry potential risks and side effects, including but not limited to:
- Bruising and Swelling: Some patients may experience bruising, redness, or swelling at the injection site.
- Pain or Discomfort: Mild to moderate pain or discomfort may occur during and after the injection.
- Infection: There is a risk of infection at the injection site.
- Allergic Reactions: Rarely, patients may have allergic reactions to the injected substances.
- Asymmetry or Uneven Results: There is a possibility of uneven results or facial asymmetry.
- Temporary Drooping: Botox injections can sometimes cause temporary drooping of the eyelids or eyebrows.
- Nerve Damage: Although rare, there is a risk of nerve damage, which can result in changes in facial expression or sensation.
- Lump Formation: Formation of lumps or nodules under the skin may occur with dermal fillers.
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Pre-Treatment Instructions: Follow all pre-treatment instructions provided by your healthcare provider to minimize risks.
- Post-Treatment Care: Follow all post-treatment care instructions to ensure proper healing and optimal results.
Weight Loss and Life-Style Coaching
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving weight-loss instruction and peptide therapy, including the use of medications such as semaglutide and tirzepatide. Please read this section carefully and discuss any questions or concerns with your healthcare provider before proceeding.
Semaglutide, Tirzepatide, and Liraglutide are contraindicated in patients with a personal or family history of certain types of thyroid cancer, specifically thyroid C-cell tumors such as medullary thyroid carcinoma (MTC), or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2), pancreatitis, chronic kidney disease, biliary disease, type 1 diabetes, diabetic retinopathy, type 2 diabetes on insulin and mental health issues.
Procedure: Peptide therapy with medications such as semaglutide and tirzepatide aims to enhance weight loss by regulating appetite and metabolism.
Potential Benefits:
- Significant weight loss
- Improved blood sugar control
- Reduced risk of obesity-related health conditions
- Enhanced overall well-being and quality of life
- Convenience of receiving instructions and treatments at home
Potential Risks and Side Effects: While weight-loss instruction and peptide therapy are generally safe, they do carry potential risks and side effects, including but not limited to:
Semaglutide and Tirzepatide:
- Gastrointestinal Issues: Nausea, vomiting, diarrhea, or constipation.
- Hypoglycemia: Low blood sugar levels, especially if combined with other medications for diabetes.
- Injection Site Reactions: Redness, swelling, or pain at the injection site.
- Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain.
- Gallbladder Problems: Including gallstones or inflammation of the gallbladder.
- Kidney Issues: Worsening of kidney function in some patients.
- Allergic Reactions: Rarely, allergic reactions to the medication.
Weight-Loss Instruction:
- Nutritional Deficiencies: Risk of deficiencies if dietary recommendations are not balanced.
- Overexertion: Risk of injury or health issues from excessive or improper exercise.
- Psychological Impact: Potential stress or anxiety related to dietary and lifestyle changes.
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Pre-Treatment Instructions: Follow all pre-treatment instructions provided by your healthcare provider to minimize risks.
- Post-Treatment Care: Follow all post-treatment care instructions to ensure proper health management and optimal results.
- Regular Monitoring: Regular follow-ups with your healthcare provider are essential to monitor progress and adjust treatment as needed.
Testosterone Therapy
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving testosterone shots. Please read this section carefully and discuss any questions or concerns with your healthcare provider before proceeding.
Procedure: Testosterone therapy involves the administration of testosterone injections to treat low testosterone levels. This therapy aims to restore and maintain optimal testosterone levels, thereby alleviating symptoms associated with testosterone deficiency.
Potential Benefits:
- Improved energy levels and mood
- Enhanced sexual function and libido
- Increased muscle mass and strength
- Reduced body fat
- Improved bone density
- Better cognitive function
Potential Risks and Side Effects: While testosterone shots are generally safe, they do carry potential risks and side effects, including but not limited to:
- Injection Site Reactions: Pain, redness, swelling, or infection at the injection site.
- Hormonal Imbalance: Over- or under-treatment can lead to symptoms of hormonal imbalance.
- Acne and Oily Skin: Increased testosterone levels can cause or exacerbate acne and oily skin.
- Fluid Retention: Potential for fluid retention, which can cause swelling in the ankles and feet.
- Sleep Apnea: Testosterone therapy may worsen existing sleep apnea.
- Polycythemia: Increased red blood cell count, which can thicken the blood and increase the risk of clotting.
- Gynecomastia: Development of breast tissue in men.
- Prostate Issues: Potential enlargement of the prostate and increased risk of prostate cancer.
- Mood Changes: Possible mood swings, aggression, or irritability.
- Cardiovascular Risks: Increased risk of heart disease, stroke, and other cardiovascular issues.
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Pre-Treatment Instructions: Follow all pre-treatment instructions provided by your healthcare provider to minimize risks.
- Post-Treatment Care: Follow all post-treatment care instructions to ensure proper health management and optimal results.
- Regular Monitoring: Regular follow-ups with your healthcare provider are essential to monitor testosterone levels and overall health.
Additional and Affiliate Services and Solutions
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving point of care services or recommendations to include but not limited by the following. Please read this section carefully and discuss any questions or concerns with your independent health care provider before proceeding.
Additional Services:
- Serum Tears - As disclosed above and other regenerative solutions.
- Sports Recovery - Pre and Post workout drinks and supplements and protein drinks.
- Sleep Improvement - Oral solutions and on-going sleep monitoring.
- Restoring Balance - Oral solutions for hangovers and restoring clarity and cognitive improvement.
- Coaching services - as part of above services rendered.
Potential Benefits:
- Restoration of function
- Improved cognitive health
- Quicker Recovery.
- Reduction of inflammation
- Regenerative potential
Potential Risks and Side Effects: All solutions have been adequately vetted by their own industry standards. These affiliate solutions are readily available through their individual websites. We provide education and offer these solutions within our services in an effort to provide holistic health and wellness services..
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Pre-Treatment Instructions: Follow all pre-treatment instructions provided by your healthcare provider to minimize risks.
- Post-Treatment Care: Follow all post-treatment care instructions to ensure proper health management and optimal results.
PALA Serum Tears
Purpose: The purpose of this section is to inform you about the potential risks, benefits, and procedures involved in receiving PALA (Platelet and Leukocyte-rich Autologous) serum tears. Please read this document carefully and discuss any questions or concerns with your healthcare provider before signing.
Procedure: PALA serum tears are created using a sample of your own blood, which is processed to extract the platelet and leukocyte-rich serum. This serum is then diluted and used as eye drops to promote healing and provide relief from symptoms of dry eye and other ocular surface diseases.
Potential Benefits:
- Enhanced healing of the ocular surface
- Relief from dry eye symptoms
- Improved lubrication and comfort
- Reduced inflammation
- Promotion of epithelial cell growth and regeneration
Potential Risks and Side Effects: While PALA serum tears are generally safe, they do carry potential risks and side effects, including but not limited to:
- Infection: There is a risk of infection at the site where blood is drawn or if the serum tears become contaminated.
- Bruising and Hematoma: Some patients may experience bruising or the formation of a hematoma at the blood draw site.
- Pain or Discomfort: Mild pain or discomfort may occur during the blood draw or when applying the serum tears.
- Allergic Reactions: Although rare, there is a possibility of an allergic reaction to the serum tears.
- Eye Irritation: Temporary irritation, redness, or discomfort in the eyes after applying the serum tears.
- Contamination Risk: Improper handling or storage of the serum tears can lead to contamination and potential eye infections.
- Variability in Efficacy: The effectiveness of the treatment can vary depending on the individual’s condition and response to the serum tears.
Important Considerations:
- Medical History: Inform your healthcare provider of your complete medical history, including any allergies, medications, and underlying health conditions.
- Current Medications: Provide a list of all medications you are currently taking to avoid potential interactions.
- Sterile Technique: Ensure that you follow proper sterile techniques when handling and applying the serum tears to minimize the risk of contamination.
- Storage: Follow all storage instructions provided by your healthcare provider to maintain the efficacy and safety of the serum tears.
- Monitoring: Regular follow-up appointments with your healthcare provider are essential to monitor the treatment’s effectiveness and address any concerns.
I acknowledge and agree that Sacred Owl Solutions, Samantha O’Dell, and the Big Horn Health Expo are not responsible or liable for any injury, damages, or issues arising from the IV or injection services provided or by Salt Hydration & Wellness at this event. I assume full responsibility for any risks associated with the services received.
Acknowledgment and Consent: By signing the consent document, you acknowledge that you have read and understood the information provided above. You have had the opportunity to ask questions and have received satisfactory answers. You understand the potential risks and benefits associated with Salt Hydration & Wellness services and agree to proceed with the treatments.
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