I understand that photographs and videos may be taken for the sole purpose of clinical documentation within the practice and for the prescribing Doctor.

I understand that in-clinic images are stored securely and will not be used in any public or promotional media without my separate written consent.

I give consent to share photographs and digitally recorded videos for use in any public media, including social media, internet, television, radio, print, or any of the organisation's publications or promotional content.

• I understand this is solely for advertising, marketing, fundraising and/or promotional purposes.
• I acknowledge this consent comes without expectation of monetary compensation or other benefit.
• I understand the organisation will send previews of material involving my image prior to publication for my approval.

I confirm that all information provided in this form is accurate and complete to the best of my knowledge. I understand that withholding or providing incorrect information may affect the safety or suitability of my treatment.

I understand that IV vitamin therapy is an elective wellness service and is not a substitute for medical advice, diagnosis, or treatment. I have been encouraged to consult my GP regarding any medical concerns.

I consent to The Vitamin Guy administering IV therapy as discussed and agreed. I acknowledge the following risks associated with IV therapy: bruising, discomfort, phlebitis, allergic reaction, infection, or extravasation at the cannula site. I understand these risks are rare and that the treating clinician is a qualified Registered Nurse.

I understand I may withdraw consent at any time during the procedure without penalty.

I acknowledge that my personal health information is collected in accordance with the Australian Privacy Act 1988 and will be stored securely, used only for treatment and communications I have consented to.

I declare that I am 18 years of age or older, or have parental/guardian consent if under 18.

By signing, I acknowledge that results are not guaranteed, and that refunds will not be offered for procedures I have consented to with full awareness of the associated risks.