EBOO Questionnaire

Ozone IV Therapy at Health & Heart Natural Medicine

EBOO Treatment

appointment request form

Please fill out this questionnaire and someone will get back to you shortly. If you simply want to inquire about the price, you can text (575)-733-0707.

Do you take copper/iron supplements (oral or IV)? *
Do you have RA/AS, autoimmune disease, Lyme disease or cancer? *
Are you currently pregnant? *
Do you have thyrotoxicosis? *
Do you have hemophilia? *
Do you have low platelet count? *
Do you have atopic dermatitis? *
Do you have uncontrolled hyperthyroidism (Graves Disease)? *
Do you experience seizures? *
Do you have a history of heart attacks? *
Do you have low G6PD? *
Do you take photo active medication or are you photosensitive? *
Do you have a history of thick blood? *
Do you take blood thinners? *
Have you had blood clots in past 6 months? *
Do you have myocarditis? *
Have you had a stroke in the last 6 months? *
Have you had EBOO treatment before? *
Are you allergic to heparin? *
Do you take anticoagulants? *
Are you anemic? *
Do you smoke (tobacco or cannabis)? *
Have you had any of the following lab tests done in the last 6 months? *