Peek-A-View Baby 3D/4D Disclaimer:
Peek-A-View Baby understands the importance of proper prenatal medical care for both the expectant mother and the fetus. Therefore, in order to provide our clients with appropriate, meaningful ultrasound sessions, Peek-A-View Baby requires that you:
1) Certify that you are under the care of a physician or other healthcare provider, and that you are not obtaining this ultrasound as a replacement for, or in lieu of standard prenatal medical care; and
2) Provide your OB/GYN name, practice name, and phone number
As a further condition to receiving ultrasound services from Peek-A-View Baby, you hereby acknowledge, understand, and agree to the following statements:
• This ultrasound is an elective procedure that I have voluntarily requested and is not intended to take the place of a diagnostic ultrasound or any other test or treatment that has been or may be recommended by your healthcare provider.
• Because of its elective nature, this ultrasound is not covered by insurance. Advanced payment is required.
• The person who performs this ultrasound, while qualified to provide such service, is not a doctor, nurse, or healthcare provider, and cannot interpret, diagnose medical conditions from, or otherwise offer medical conclusions regarding the images produced.
• As used by Peek-A-View Baby, this ultrasound is intended to provide enhanced images for the purpose of viewing fetal movement in utero. The technician will make no attempt to guarantee a medically inclusive ultrasound or fetal well-being.
• That you are responsible for contacting your own healthcare provider if you have any questions concerning this ultrasound or any other aspect of this pregnancy.
• That the quality of the ultrasound and the DVD/CD/flash drive depends upon many factors including, but not limited to: body tissue content, developmental state and fetal position. You understand that Peek-A-View Baby does not guarantee the quality of the digital media, or the ability to visualize any characteristics of the fetus.
• We often share images on social media. We take your privacy seriously and ALWAYS protect your identity by cropping out all names.
• I authorize Peek-A-View Baby 3D/4D to disclose medical information to my healthcare provider if necessary.
• That I am financially responsible for charges related to this ultrasound.