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AA Health Solutions, LLC DBA Evolve Your Bod
Effective Date: March 2026
IMPORTANT: MOBILE IV THERAPY SERVICES MAY BE SUBJECT TO ADDITIONAL STATE LICENSURE REQUIREMENTS, INCLUDING TEXAS HHSC HOME AND COMMUNITY SUPPORT SERVICES AGENCY (HCSSA) LICENSURE AND HOME-INFUSION REGULATIONS. EVOLVE YOUR BOD IS ACTIVELY REVIEWING THESE REQUIREMENTS WITH LEGAL COUNSEL. THIS DOCUMENT WILL BE FINALIZED UPON COMPLETION OF THAT REVIEW.
This Mobile IV Therapy Service Disclosure and Consent (“Consent”) applies to patients receiving IV therapy services at a location other than a traditional clinical setting, such as your home, office, hotel, or other designated location, through the Evolve Your Bod Mobile IV care model.
Your Mobile IV encounter involves the following:
– Evolve Your Bod (AA Health Solutions, LLC) — the technology and care coordination platform that coordinated your intake, scheduling, and administrative services. Evolve does not practice medicine.
– The Rendering Medical Group and Ordering Physician — the independent Medical Group and its affiliated licensed physician who reviews your medical information, determines that IV therapy is clinically appropriate, and issues the IV therapy order.
– The Mobile Nurse — a licensed registered nurse (RN) or higher-level clinical professional who travels to your designated location, verifies your identity and health status, and administers IV therapy under the physician’s order.
Mobile IV therapy is limited to the administration of IV fluids, vitamins, minerals, and therapeutic formulations as ordered by your physician. Mobile IV services do not include:
– Emergency medical care or acute medical treatment.
– Administration of blood products or chemotherapy.
– Surgical or invasive procedures.
– Ongoing home health services (this is a single-encounter service model).
The mobile nurse will verify that your location is safe and suitable for IV administration before beginning the service. If the nurse determines that the location is unsafe or clinically inappropriate, the service may be postponed or cancelled.
All Mobile IV therapy is administered pursuant to an order from a licensed physician. The mobile nurse will:
– Verify your identity using valid identification.
– Confirm your allergies, medications, and relevant medical history.
– Review the IV formulation with you before administration.
– Administer the IV in accordance with the physician’s order and established clinical protocols.
– Monitor you during and after administration for adverse reactions.
– Follow established emergency escalation protocols if an adverse event occurs, including calling 911 if necessary.
– Document the encounter and transmit records securely to the rendering Medical Group and Evolve Your Bod.
Mobile IV therapy carries the same inherent risks as IV therapy administered in a clinical setting (see IV Therapy Treatment Consent for a complete list of risks). Additional risks specific to the mobile setting may include:
– The service location may not have the same emergency response infrastructure as a clinical facility.
– Emergency medical services (EMS) response time may vary depending on your location.
– Environmental factors (lighting, temperature, cleanliness) at your location may affect the safety and comfort of the procedure.
– The mobile nurse carries a limited supply of emergency intervention materials compared to a fully equipped clinical facility.
If you experience a medical emergency during or after mobile IV therapy, call 911 immediately.
Mobile IV therapy services rendered by the Medical Group or affiliated providers may be eligible for insurance coverage. The rendering provider, or Evolve Your Bod acting as a billing agent on their behalf, is responsible for insurance verification, billing, and claims submission. You are responsible for any copays, deductibles, coinsurance, or balances not covered by your insurance plan.
Mobile IV therapy services may be subject to additional state licensure requirements under Texas law, including Home and Community Support Services Agency (HCSSA) licensure and home-infusion regulations administered by the Texas Health and Human Services Commission (HHSC). Evolve Your Bod is actively reviewing these requirements with legal counsel to ensure full compliance before Mobile IV services are offered. By using Mobile IV services, you acknowledge that this care model is subject to applicable state and federal regulations regarding in-home infusion services.
By signing below, electronically accepting this Consent through the Evolve Your Bod platform, clicking ‘I Agree,’ checking the associated consent box, or proceeding with mobile IV therapy after being presented with this Consent, you affirm:
– I understand that Mobile IV therapy is administered at a non-clinical location under a physician’s order by a licensed nurse.
– I understand the risks specific to receiving IV therapy outside of a clinical setting.
– I have disclosed all known allergies, medications, supplements, and relevant medical conditions.
– I understand the emergency protocols and that 911 may be called if necessary.
– I will ensure that my service location is safe, clean, and accessible for the mobile nurse.
– I have the right to refuse or discontinue IV therapy at any time.
– I consent to the documentation and sharing of my encounter records with Evolve and the Medical Group.
– I understand that Evolve is a technology platform and does not practice medicine.
– I have reviewed and signed the IV Therapy Treatment Consent in addition to this document.
Evolve Your Bod (AA Health Solutions, LLC)
5521 Bellaire Drive South, Suite 200, Fort Worth, TX 76109
Email: info@evolveyourbod.com | Phone: 866-301-3141
Patient Signature (or Electronic Acceptance) | Date |
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