Hayfever, B12 and vitamins with Dhianna Referring dentist * Pt name * First Name Last Name Number * Pt address * Pt DOB * Practice patient is registered at * New Parks Wicklow Netherhall Saffron MH and/or other comments Type of treatment (multiple can be chosen) * B12 Hayfever (single only) Fat burner Glutathione Biotin Vitamin C IV infusions (various) Treatment duration * Single Course of 5 Thank you for filling and submitting one of the three wellness treatment form. One of our staff members will be in contact with the patient as soon as possible.
