This is an informed-consent document that has been prepared to help your doctor inform you about B12 injections, its risks as well as alternative treatments. It is important that you read this information carefully and completely. You will be asked to electronically sign this consent form below.
Vitamin B12 helps maintain good health and has been shown to be beneficial in helping to reduce stress, fatigue, improve memory and cardiovascular health, and maintain a a good body weight. It can also assist the body in converting proteins, fats and carbohydrates into energy and is necessary for healthy skin and eyes.
ALTERNATIVE TREATMENTS
B12 injections are better absorbed by the body since they go directly into the blood stream. Alternatives to B12 injections are oral vitamins, B12 patch, lozenges, liquid drops and nasal spray.
RISKS OF VITAMIN B12 INJECTIONS
Vitamin B12 injections common side effects include:
• diarrhea
• upset stomach
• nausea
• pain and swelling at the site of injection
• fatigue
• malaise
• fever
• headache
• joint pain
Although rare, Vitamin B12 injections can also result in serious side effects such as:
• rapid heartbeat
• chest pain
• flushed face
• muscle cramps and weakness
• dizziness
• confusion
• hives
• rash
• difficulty swallowing
• shortness of breath
• wheezing and coughing
These side effects should be reported to the physician immediately to be further evaluated.
ADDITIONAL INFORMATION
I understand that certain herbal products, vitamins, minerals, nutritional supplements, prescription and non prescription medications may result in side effects when they interact with B12 injections.
By signing below, I acknowledge that I have read this informed consent in detail and agree to the treatment with its associated risks.
I hereby give consent to perform this and all subsequent Vitamin B12 injections.
I hereby release the doctor, injecting Vitamin B12 and the facility from liability associated with this procedure.
