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IV Interest Form
First and Last Name
*
Best Phone Number(start with a 1 then area code)
*
I want an IV
I want an IV
Normal Saline fluids
Myers Cocktail(B-complex,B12,Zinc, Magnesium, Vitamin C, Glutathione)
NAD
Medications (Zofran, Pepcid, Benadryl)
I Live In
I Live In
Mesa
Queen creek
Scottsdale
Tempe
Phoenix
Chandler
Gilbert
Other
Submit
