DAVID A. EDWARDS, MD, H.M.D.
LTD
PRACTICE LIMITED TO
INTEGRATIVE MEDICINE
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615 Sierra Rose Drive, Suite 3
Reno, NV 89511
(775) 828-4055
Fax (775) 828-4255
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CONSENT FOR PARENTERAL (IV/IM) NUTRITIONAL,
VITAMIN AND/OR MINERAL THERAPY
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The use of intravenous and/or intramuscular
nutrients (called parenteral nutrition), including amino acids, vitamins,
minerals and other nutrients allows direct access to the metabolism without
requiring proper or optimal functioning of the organs of digestion, including
stomach, small intestine, large intestine, liver and/or pancreas as well
as the entire ensemble of digestive enzymes. The use of nutrients in this
way is referred to scientifically as
ORTHOMOLECULAR MEDICINE. In
some cases the nutrients are used to induce optimal function of the metabolism.
In other cases the nutrients may be used in higher than replacement amounts
to achieve a general or specific metabolic effect. For example, higher
dose of the B vitamin "niacin" (vitamin B-1) is used medically
to lower cholesterol and triglycerides. Similarly, high doses of vitamins
B-1, B-6 and Folic acid are used to lower elevated blood Homocysteine
levels (levels of Homomcysteine above 9 ng/dl are associated with a progressively
increasing risk for heart attack, stoke and/or peripheral vascular disease,
also called "hardening of the arteries"). In addition, the use
of intravenous nutrition, including amino acids, vitamins, tropic factors
and/or minerals is common in many chronic, degenerative diseases as general
metabolic support for optimal self-healing. Orthomolecular medicine is
also commonly used to help fight infections, allergies and the effects
of stress. Finally, parenteral nutritional methods are commonly used for
correcting sub-clinical problems and for disease prevention.
Although the use of Orthomolecular Medicine
is completely legal in the state of Nevada under Nevada Law (Nevada Revised
Statutes 630A.040(2), in many cases the treatments are
NOT COVERED
BY MEDICARE and may
NOT be covered by private insurance.
In the case of private insurance, however, there is no way of knowing
whether or not the treatment will be covered until the patient submits
the claim for reimbursement. The receipt provided by Bio Health Center
is complete with the treatment used, appropriate diagnosis and
ALL
other information legally required for the insurer to process the claim
as submitted. Therefore, patients are encouraged to submit their claims
for reimbursement.
SIDE EFFECTS are generally mild and may include
pain an/or irritation at the injection site, brief light headedness, dizziness,
warmth, flushing, transient nausea or rash or, rarely, true allergy. Any
and all questions about my use of Orthomolecular Medicine methods have
been answered to my complete satisfaction by my physician and/or the staff
of Bio Health Center.
I HAVE READ, UNDERSTAND AND GIVE MY
CONSENT TO THE ABOVE.
Signature:
Date:
Witness:
Date: