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Client Liability Waiver

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Baby's due date
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Client Waiver


  • ●  Prenatal Care: I acknowledge that I have been informed by Little Blessings 3D/4D that prenatal care is important to a healthy pregnancy.

  • ●  Concerns Should Be Referred to Physician: I have also been informed by Little Blessings 3D/4D that the use of Little Blessings 3D/4D's services cannot substitute for care of a physician. If I have any concerns regarding

    my pregnancy, I will contact my doctor. I will in no way rely upon Little Blessings 3D/4D or its services for medical advice.

  • ●  No Professional Negligence Claims: I am purchasing Little Blessings 3D/4D services and products for keepsake, non-medical purposes. I agree that I have no right to recourse against Little Blessings 3D/4D 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 child. This includes any claim for error in gender determination.

  • ●  Assumption of Risks: I acknowledge that there is inherent risk in any activity involving a fetus and there are potential risks in this type of activity. I understand Little Blessings 3D/4D follows FDA recommendations for length of scan and frequency of ultrasound sound waves, and that no detrimental effects have been found in 40 years of studies. I hereby voluntarily assume all risk of harm or injury to me or my baby resulting from the services provided by Little Blessings 3D/4D.

  • ●  Waiver and Release of Claims: I hereby waive, release, acquit and forever discharge Little Blessings 3D/4D, its owner or its employees from any and all claims, expenses, demands, costs, causes of action, and other actions and liabilities, of any nature whatsoever, whether known or unknown, whether in law or equity, that I or my baby may have arising out of or in any way related to my visit to Little Blessings 3D/4D. I agree that I shall have no right whatsoever to file any lawsuit or institute any other action or legal proceedings of any type arising out of or in any way related to my visit to Little Blessings 3D/4D.

  • ●  Photo Release: I give Little Blessings 3D/4D permission to post or use any photos or recorded data for advertisement purposes. I understand no names will be posted or used with the photos.

  • ●  Picture Quality: I understand picture quality is dependent on many factors. (fluid levels, Placenta placement, baby position and maternal body composition) I understand that Little Blessings 3D/4D is not always able to obtain pictures of every baby. I understand no refunds are available if unable to obtain pictures or gender. I understand BMI of 35 and higher will yield lower clarity images.

    I will notify my physician that I have chosen to obtain an elective fetal ultrasound from Little Blessings 3D/4D & I understand my physician has not ordered this. I understand that this ultrasound is not to be used to replace physician care. I have been informed that the federal Food and Drug Administration has determined that the use of medical ultrasound equipment for reasons other than medical purposes, without a physician’s prescription, is an unapproved use.

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Date waiver was accepted by client
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Little Blessings 3D/4D ultrasound studio provides elective and keepsake ultrasounds. While we are professionals and medically trained, we are not physicians. Therefore, we cannot provide any diagnosis or medical information about the health or condition of yourself or your baby. We are strictly for fun and enjoyment. As we are focusing on baby's face we will not and do not provide a medical survey of baby.

239-572-1851

861 SE 47th Terrace Unit 5

Cape Coral, Florida 33904

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