Natural Medicines | IV Drip | Holistic Care

Non-Member Patient Medi Pain IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Medi Histamine IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Medi Hangover Severe IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Medi Hangover Mild IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Medi Fever IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Medi Diuretic IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Electro Mag IV Infusion

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Infusion Base *

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Medi Belly IV Infusion

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Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Electro NAC IV Infusion

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Infusion Base *

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Electro Lite IV Infusion

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Infusion Base *

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Electro Gluta IV Infusion

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Infusion Base *

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Electro B-Max IV Infusion

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Infusion Base *

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Slim IV Infusion

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Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- L-Carnitine
- Glutathione

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Silver IV Infusion

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Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B2-B3-B5-B6-B7-B12
- Silver Hydrosol
- Magnesium Sulfate

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Joints IV Infusion

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Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- Collagen
- Glutathione
- Condroitin Sulfate
- DMSO
- Magnesium Sulfate

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Hydrate IV Infusion

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Infusion Base *

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Heavy Metals IV Infusion

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Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- EDTA

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Flu Support IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- Silver Hydrosol
- Magnesium Sulfate

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Fitness IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- L-Carnitine
- Magnesium sulfate

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Derma IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- Collagen
- Condroitin sulfate
- Glutathione
- Magnesium sulfate

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Spike IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- EDTA
- Glutathione
- NAC
- Compound IN Nigella Sativa

Oral Supplements:
- Jamu Jo 14 Star Anise 250 ml
- Compound SIP

You may also customize this IV with the Ala Carte Menu.

Vitamin D

Vitamin D injection (no more than once every 3 months)
Vitamin D pill (no more than once per week)
None

Bath Kit

Neem Boron Soap 250 ml
Vita Bath with Compound SO
None

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free).

Total

Rp. 0

Non-Member Patient Vita Covid IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Glutathione
- NAC
- Magnesium Sulfate
- Ringer's Lactate

Oral Supplements:
- Jamu Jo 14 Star Anise 250 ml
- Jamu Jo 15 Sambiloto 250 ml
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Vitamin B

(IB-3) Vitamins B1-B6-B12 (no more than once per week)
(IB-X) Vitamins B1-B2-B3-B5-B6-B7-B12 (no more than once every 2 weeks)
None

Vitamin D

Vitamin D injection (no more than once every 3 months)
Vitamin D pill (no more than once per week)
None

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Brain IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B2-B3-B5-B6-B7-B12
- Piracetam
- L-Carnitine

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Booster IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12
- Magnesium Sulfate

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Non-Member Patient Vita Basic IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

Included with this IV are...
- Ringer's Lactate 4 types of electrolyte salts
- Vitamins B1-B6-B12

Oral Supplements:
- Ascorbic Acid Vitamin C
- BSI Compound M2

You may also customize this IV with the Ala Carte Menu.

Patient Name *

Email *

Confirm Email

We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Talk to Practitioner

I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

Total

Rp. 0

Member Patient Medi Hangover Severe IV Infusion

Please enable JavaScript in your browser to complete this form.

Infusion Base *

This infusion cannot be combined with other ingredients.

Patient Name *

Email *

Confirm Email

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Time

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I have pain in the kidneys
I have hot or burning urine
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(If female) I am pregnant or breast feeding
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Jimbaran
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Ubud

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Member Patient Vita Basic IV Infusion

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Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
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(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
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Jimbaran
Canggu
Ubud

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Member Patient Vita Booster IV Infusion

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Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

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Jimbaran
Canggu
Ubud

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Member Patient Vita Brain IV Infusion

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Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
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(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
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Jimbaran
Canggu
Ubud

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Member Patient Vita Derma IV Infusion

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Time

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I have pain in the kidneys
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(If female) I am pregnant or breast feeding
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I have or have been treated for cancer
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Jimbaran
Canggu
Ubud

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Member Patient Vita Fitness IV Infusion

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Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

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Jimbaran
Canggu
Ubud

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Member Patient Vita Flu Support IV Infusion

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Time

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I have pain in the kidneys
I have hot or burning urine
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I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

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Jimbaran
Canggu
Ubud

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Member Patient Vita Heavy Metals IV Infusion

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Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

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Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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Member Patient Vita Joints IV Infusion

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Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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Member Patient Vita Silver IV Infusion

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Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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Member Patient Vita Slim IV Infusion

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Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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Member Patient Vita Hydrate IV Infusion

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Electro B-Max IV Infusion

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Electro Gluta IV Infusion

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Infusion Base *

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Electro Lite IV Infusion

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Electro Mag IV Infusion

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi Belly IV Infusion

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This infusion cannot be combined with other ingredients.

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi Diuretic IV Infusion

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This infusion cannot be combined with other ingredients.

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Electro NAC IV Infusion

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi Fever IV Infusion

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This infusion cannot be combined with other ingredients.

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Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi Hangover Mild IV Infusion

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Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi Histamine IV Infusion

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Phone / WhatsApp *

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi Pain IV Infusion

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Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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Member Patient Medi TPN IV Infusion

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Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

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I need to talk with a BSI Practitioner before my IV. (A very short consultation is free). There may be a short wait if the doctor or nurse practitioner is with another patient.

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We respect your privacy. BSI does not give personal information to outside parties. We request contact info in the event of schedule changes or emergency situations

Requested Day & Time *

Date

Time

Important medical questions *

I have pain in the kidneys
I have hot or burning urine
I have a blood-related disease or frequent bleeding
I am anemic
(If female) I am pregnant or breast feeding
(If female) I am presently menstruating
I have or have been treated for cancer
None of these

Other condition not listed. Please comment...

Where would you like your appointment ? *

Jimbaran
Canggu
Ubud

Infusion Base *

Vitamin B

(IB-3) Vitamins B1-B6-B12 (not more than once per week)
(IB-X) Vitamins B1-B2-B3-B5-B6-B7-B12 (No more than once every 2 weeks)
None

Vitamin D

Vitamin D Injection (Direct injection to body, not IV) (minimum 3 months between doses, Doctor Rx required)
Vitamin D (pill)
None

Minerals

Magnesium Sulfate 1 cc in 40% solution
Selenium 3 cc (not more than once every 2 weeks)
Silver Hydrosol (Doctor prescription only)
Iron
Zinc

(Choose between MINERALS or EDTA) (Choose max 3 in this category)

EDTA / Chelation Therapy

EDTA 1/4 gram (Doctor prescription only) (CAUTION! If EDTA is added, can’t add minerals) No Magnesium, No Selenium, No Iron, No Silver Hydrosol

(Choose between EDTA or MINERALS)

Medicines & Boosters

DMSO (Doctor prescription only)
NAC (not more than once every 2 days)
Lysine

Amino Acids

L-Carnitine (IV bolus administration)
L-Creatine (direct injection, not IV)
None

Body Enhancement

Glutathione
Collagen
Condroitin Sulfate

(Choose max 2 in this category)

Homeopathic / Base Medicines

Compound IN (Nigella Sativa)
Compound IP (Soursop)
Compound IL (Mangosteen Pericarp)
Compound IZ (Zingerberaceae)

(Choose max 2 in this category – BSI Exclusive)

Brain Booster

Piracetam (Doctor prescription only)

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Non-Member Medi TPN IV Infusion

Medi TPN

B Braun Nutriflex IV Infusion

Name

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Requested Day & Time

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Jimbaran