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Service
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Info
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Health Form
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Consent
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Pay

Choose your treatment

Select the IV drip that fits your goals today.

Myers Cocktail
The gold-standard IV blend. Boosts energy, immunity & overall wellness.
From $200· 45 min
Jet Lagged Drip
IV fluids, electrolytes, Zofran, Vitamin C, Toradol, Zinc, B12 & B-Complex.
From $250· 50 min
NAD+ Drip
Clarity, energy, anti-aging. Available in 250MG, 500MG, 750MG & 1000MG.
From $300· 60–120 min
Immunity Drip
High-dose Vitamin C, Glutathione, zinc, B-vitamins & Magnesium.
From $200· 45 min
Hangover Drip
Rapid relief from headache, nausea & fatigue. Zofran add-on available.
From $170· 45 min
Baby Bump Drip
Prenatal hydration with B12, B-Complex, Folic Acid & Vitamin C.
From $185· 45 min
Post-Partum Drip
Recovery support for new mothers. Folic acid, B12, B-Complex & Vitamin D IM injection.
From $185· 45 min
Migraine Relief
Fast-acting blend: Toradol, Zofran, Magnesium, B12, B-Complex & Vitamin C.
From $270· 50 min
Master Drip
Flu & sickness relief. High-dose Vitamin C, Glutathione, B-Complex, Zinc & Magnesium.
From $295· 50 min
Energy & Performance
For athletes & active lifestyles. Electrolytes, B-Complex, Taurine, L-Carnitine & amino blend.
From $185· 50 min
Cold & Flu Drip
Vitamin C, Toradol, Zofran, B12, B-Complex, Zinc & electrolytes for fast recovery.
From $300· 50 min
Pure Hydration
Essential IV hydration, vitamins & minerals. The cleanest reset for your body.
From $130· 40 min
Glow Up Drip
Skin elasticity, collagen & anti-aging. Glutathione, NAD+, Biotin, Vitamin C & Zinc.
From $300· 55 min

Personal information

Basic details for your appointment and records.

Patient Information
Emergency Contact
Appointment Preference

Health intake form

This helps our medical team prepare the safest, most effective treatment for you.

Primary Care Physician
Medical History

Check all that apply:

Pregnancy & Reproductive Health
Current Medications & Supplements
Allergies
Current Symptoms & Wellness Goals

What brings you in today? (Check all that apply)

Lifestyle Factors
Previous IV Therapy Experience

Informed consent

Please read the full consent form and sign below.

The Drip Room — IV Therapy Informed Consent & Liability Waiver

I, the undersigned, voluntarily consent to receive intravenous (IV) therapy services provided by The Drip Room located at 8188 N Telegraph Rd, Dearborn Heights, MI 48127.

1. Nature of Services. IV therapy involves the direct administration of vitamins, minerals, electrolytes, and other nutrients into the bloodstream via an intravenous catheter. I understand this is a wellness service and not a substitute for professional medical care or treatment of any diagnosed medical condition.

2. Risks & Side Effects. I acknowledge that IV therapy carries risks including: bruising or soreness at the injection site, phlebitis, infection, allergic reactions, dizziness, nausea, lightheadedness, and in rare cases more serious adverse reactions.

3. Medical Disclosure. I confirm that all medical information provided on this form is accurate and complete. I understand that failure to disclose accurate information may increase the risk of adverse reactions. I am not pregnant, do not have active kidney disease, congestive heart failure, or any condition contraindicating IV fluids, unless already disclosed above.

4. No Medical Advice. Services provided do not constitute medical advice, diagnosis, or treatment. I have been advised to consult my physician before undergoing IV therapy if I have underlying health conditions.

5. Release of Liability. I hereby release, waive, and discharge The Drip Room, its owners, employees, and agents from any claims, damages, or losses arising from the IV therapy services I receive, to the fullest extent permitted by law, except in cases of gross negligence or willful misconduct.

6. Right to Refuse Treatment. The Drip Room reserves the right to refuse or discontinue treatment if, in the clinical team's judgment, it is not safe to proceed.

7. Cancellation Policy. Cancellations less than 24 hours before a scheduled appointment may result in a fee of up to 50% of the session price.

8. Photography. I may be asked separately for consent to use session photographs for marketing. No images will be shared without additional written consent.

I have read and fully understand the IV Therapy Informed Consent & Liability Waiver above and voluntarily agree to its terms.
I confirm that all health information I have provided is accurate and complete to the best of my knowledge.
I understand this is a wellness service and not a substitute for medical care. I have been advised to consult my physician if I have concerns.
I am 18 years of age or older and legally competent to sign this consent.
Typing your full name constitutes your legal electronic signature.

Review & pay

Confirm everything looks right, then complete secure payment.

Booking Summary

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Your session is reserved and payment confirmed. We'll send a confirmation to your email and reach out to finalize your exact appointment time.

Service—
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Location8188 N Telegraph Rd
Dearborn Heights, MI
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