Hangover Recovery 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
Olympia Vita Complex
100 mg/ml
Amino B12
100 mg/ml 2-5 ml
N-Acetylcysteine
200 mg/ml
*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