Non-Liability Disclosure. Please read and sign.
We offer ELECTIVE 2D, 3D, 4D and HD prenatal ultrasounds for an entertainment keepsake and to provide an early bonding experience between mommy, daddy, family and friends.
This ultrasound session will not provide any medical diagnosis of any kind. These sessions are NOT to replace your scheduled diagnostic ultrasounds ordered by your physician or healthcare provider.
I acknowledge the following:
1) I am under the care of a physician and or healthcare provider for medical diagnosis and recommendations related to my pregnancy. My healthcare provider will decide and confirm my due date, and any fetal abnormalities related to my pregnancy.
2) My doctor is aware of the Bonding Moments ultrasound I will be receiving today and has no objections to me attending this ultrasound session.
3) No Professional claims. I am purchasing Bonding Moments services and products for keepsake, non-medical purposes. I agree that I have no right to recourse against Bonding Moments in any medical malpractice, professional negligence, or any medical related claim arising out of or in any way related to my pregnancy or the birth of my baby. This includes any claim for error in gender determination.
4) I certify that I am obtaining this ultrasound for ENTERTAINMENT purposes only and that I am NOT obtaining this ultrasound to replace my standard medical care.
5) At no time will our staff be permitted to give medical input or diagnose. If you have concerns about your pregnancy, please see your doctor or healthcare provider. We cannot be held responsible for detecting any abnormalities during your pregnancy. If in the event something abnormal is discovered only your physician will be notified.
6) If no fetal heartbeat is detected a Bonding Moments employee will call your doctor and direct, you to either your provider or ER. This will be at the discretion of your physician.
7) Because this is an ultrasound there is always a risk. Most people will tell you that ultrasounds are safe and carry zero risk. Unfortunately, there is always a risk even if it’s been deemed safe. We follow all guidelines set forth from the FDA. Our Machine is calibrated for obstetrics and is FDA approved. If the rules and recommendations are followed ultrasounds are safe. In 40 years, there has never been an incident however the risk is there. These are the same machines used by your OBGYN.
8) I voluntarily assume all risks of harm or injury to the baby or me resulting from these services.
9) I hereby waive, release, acquit Bonding Moments from any and all claims, lawsuits, cause of damages.
10) I give Bonding Moments permission to post or use any photos for advertisement purposes. No names will be posted.
11) No refunds are offered for services and items from the boutique.
12) I understand that every baby and mommy are different, and quality pictures are not guaranteed. Placental placement, fluid intake and fetal position can be factors in not getting quality pictures. If this happens, we can do a rescan for free.
13) I affix my signature below to indicate that I have read and understand this document.
