Obstetric Gender Ultrasound Form - Sneak-A-Peek · 2018. 12. 4. · Obstetric Gender Ultrasound...
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Phone: 415-940-4295 Email: [email protected] Obstetric Gender Ultrasound Form The undersigned understands that an obstetric ultrasound can never be 100% certain in determining the sex of an unborn child. The undersigned also understands that if Sneak- A-Peek 3D/4D Ultrasound LLC offers the predicted sex of the unborn child that it is simply estimated and in no way is the outcome (sex of the unborn child) certain. The undersigned also agrees to allow Sneak-A-Peek 3D/4D Ultrasound LLC to keep any images from the sonogram. The undersigned agrees, for herself and for her unborn child that neither she nor the unborn child, nor their respected assigns, heirs, guardians, or legal representatives will make a claim or sue Sneak-A-Peek 3D/4D Ultrasound LLC, its officers, directors, assigns, employees, agents, or independent contractors for an incorrect determination of the unborn child’s sex. I have carefully read this agreement and fully understand its contents. I agree to the terms and conditions listed above. Print Name: ____________________________________________________________ Signature: _________________________________________ Date: _______________
Transcript of Obstetric Gender Ultrasound Form - Sneak-A-Peek · 2018. 12. 4. · Obstetric Gender Ultrasound...
Phone: 415-940-4295 Email: [email protected]
Obstetric Gender Ultrasound Form
The undersigned understands that an obstetric ultrasound can never be 100% certain in determining the sex of an unborn child. The undersigned also understands that if Sneak-A-Peek 3D/4D Ultrasound LLC offers the predicted sex of the unborn child that it is simply estimated and in no way is the outcome (sex of the unborn child) certain. The undersigned also agrees to allow Sneak-A-Peek 3D/4D Ultrasound LLC to keep any images from the sonogram. The undersigned agrees, for herself and for her unborn child that neither she nor the unborn child, nor their respected assigns, heirs, guardians, or legal representatives will make a claim or sue Sneak-A-Peek 3D/4D Ultrasound LLC, its officers, directors, assigns, employees, agents, or independent contractors for an incorrect determination of the unborn child’s sex. I have carefully read this agreement and fully understand its contents. I agree to the terms and conditions listed above. Print Name: ____________________________________________________________ Signature: _________________________________________ Date: _______________
