Purpose of Service

I understand that the ultrasound session I am receiving today is elective, non-diagnostic, and for keepsake/entertainment purposes only. The purpose of this session is to obtain souvenir images and/or video of my pregnancy. By submitting this form i agree to all of the following statements.

This ultrasound is not a medical examination and is not intended to diagnose, treat, monitor, or evaluate any medical condition of myself or my baby.

No Medical Care or Diagnosis

I acknowledge and agree that:

• No medical opinions, diagnoses, measurements, interpretations, or evaluations will be provided

• This session does not replace prenatal care or medical ultrasounds

• No assessment of fetal health, growth, anatomy, heartbeat, gestational age, gender accuracy, or viability will be made

• I am encouraged to continue all routine prenatal care with my licensed healthcare provider

STUDENT / EXTERN DISCLOSURE & CONSENT

Operator Disclosure

I understand that my ultrasound session may be performed by a student, trainee, or extern who is receiving hands-on scanning experience under studio protocols.

I acknowledge that:

• The operator may not be ARDMS-certified

• The operator is not acting as a medical professional

• The session remains non-diagnostic regardless of operator training level

RELEASE OF LIABILITY & HOLD HARMLESS AGREEMENT

Assumption of Risk

I voluntarily assume all risks associated with participating in an elective ultrasound session, including but not limited to emotional distress, image quality dissatisfaction, or unexpected findings not discussed.

Release & Indemnification

To the fullest extent permitted by Texas law, I hereby release, waive, and discharge:

• Hello Sweet Baby Ultrasound Studio

• Its owners, employees, contractors, students, externs, volunteers

• Any affiliated medical director or consultant

from any and all claims, demands, damages, or causes of action arising from or related to this elective ultrasound session.

I agree to hold harmless and indemnify the above parties from any claims made by myself or on my behalf.