Membership Sign UpPlease fill out the form below to sign up. Name * First Name Last Name Phone * (###) ### #### Email * Membership Packages * Bronze $198 Silver $398 Gold $498 Address (Where We Will Infuse The Drip) * Address 1 Address 2 City State/Province Zip/Postal Code Country IV Drip Consent Form * Our Platform is designed to enable you to request intravenous hydration services (among other related services and offerings) which are provided by licensed medical professionals. Your use of our Platform will help to identify you to the licensed healthcare professional that will render the care. Your use of the Platform is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The information presented on our Platform is not intended as a substitute for diagnosis or treatment by a qualified physician. Moreover, InstaDrip recommends that you consult your physician before making changes to any current medications. Never disregard professional medical advice or delay in seeking it in an emergency. If you think you may have a medical emergency, call your doctor or 911 immediately. InstaDrip does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned anywhere on the Platform. Reliance on any information provided by InstaDrip is solely at your own risk. ALL AVAILABLE DRIPS FEATURED BY INSTADRIP ON THE PLATFORM THAT WILL BE ADMINISTERED BY LICENSED HEALTH CARE PROFESSIONALS ARE ELECTIVE TREATMENTS FOR WELLNESS AND HEALTH MAINTENANCE ONLY. AS SUCH, THESE DRIPS, INJECTIONS OR THERAPIES ARE NOT INTENDED TO TREAT OR CURE ANY DISEASE. Notwithstanding the services that InstaDrip seeks to facilitate via the Platform, InstaDrip does not condone, recommend or encourage excess alcohol consumption. Please drink responsibly. Lastly, InstaDrip reserves the right to refuse facilitating services to anyone regardless of any physicians’ assessment, and for any reason. I agree to the terms written above. I disagree the the terms written above. Credit Card Number * Expiration Date * CVC * Zip Code * Thank you for your submission. Your request will be reviewed and you will be charged your membership fee on the first of every month.
