Forms & Consent Waivers

Please find and click on the link for your upcoming service. The completion of consent/form is required before any services are rendered.

If you have any questions feel free to call/text us at 281-603-0900.

All Patients must complete the Patient Intake Questionnaire for any services provided at IVory Blanc Hydration wellness.

Step 1

Complete the Patient Intake Questionnaire. Must be completed once per year or where major health changes occur. Returning patients with a questionnaire on file do not need to complete another form unless it has been over a year since seen at IVory Blanc Hydration & Wellness.

Step 2

Click link below on the consent form for the self-care experience you have booked. If you booked multiple services you must complete each individual consent form for what you selected.

Botulin Toxin | Neurotoxin Injection Consent Form

Dermal Filler Injection Consent Form

Microchanneling/Microneedling Consent Form

Kybella Consent Form

IV Hydration & Vitamin Infusion Consent Form

B12 and Lipotropic Injection Consent Form

For Pregnant Patients

IV Hydration & Vitamin Infusion Consent Form | For Pregnant Women only

Step 3

For patients that are receiving microneedling/microchanneling services please complete the intake form to expedite your consultation and discussion of treatment plan.