Glow Up Drip Form

 
TKH2O Pro Flo Master Name *
TKH2O Pro Flo Master Name
Client Information
Client Name
Client Name
Date
Date
Date of Birth
Date of Birth
Biotin
10 mg/ml
Abscordic Acid
500 mg/ml
Vita Plus Complex
10 mg/ml 2-5 ml
Glutathione* Mix after infusion is complete
200 mg/ ml 3ml w/ ml NS over 10 min push
*IF FIRST DRIP START WITH 3ML EACH, 2ND+ GIVE 5ML EACH.
Time IV Started
Time IV Started
Time IV Ended
Time IV Ended
Date
Date