Tummy Vision Ultrasound Studio Waiver of Liability

Tummy Vision Ultrasound Studio understands the importance of proper prenatal medical care for both the expectant mother and the fetus.Therefore, in order to provide our patientswith an appropriate, meaningful ultrasound screening,Tummy Vision Ultrasoundrequires that you:{i) certify that you are under the care of a physician or other health care provider, and that you are not obtaining this ultrasound as a replacement for, or inlieu ofstandard prenatal medical care.

As a further condition to receiving ultrasound services from Tummy Vision Ultrasound Studio, you hereby acknowledge, understand and agree to the following statements:

-Thisultrasound: is an elective procedurethat I have voluntarily requested, and is not intended to take the place of a diagnosticultrasound or any other test or treatment that has been or may be recommended by your healthcare provider.

- The technician who performs this ultrasound, while qualified to provide such ultrasound servicesisnot a doctor, nurse or healthcare provider; and cannot interpret, diagnose medical conditions from, or otherwise offer medical conclusions regarding the imagesproduced. Any measurements given are estimates only and not intended for medical use or diagnosis.

- As used by Tummy Vision Ultrasound Studio, thisultrasound is intended to provide enhanced images for the purpose of viewing fetal movement in utero. Thetechnician will make no attempt to guarantee a medically inclusive ultrasound or fetal well-being.

-You understand that you are responsibleforcontacting your own healthcare provider if you have any questions concerning thisultrasound or any other aspect of your pregnancy. Since we are elective, we do not share our images with healthcare providers.

-If you are less than 6 weeks pregnant or we are not able to see baby you can return one time within two weeks of your original appointment on a weekday for only $39. Rescans are up to 10 weeks only for preganancy confirmation packages.

- Rescan appointments will be scheduled on a Monday through Friday and at the availability of Tummy Vision and their staff. The Rescan appointment must be completed within two weeks of the orginal appointment or the orginal appointment price will be charged.

- If you are a no-show, cancel or reshedule your appointment to a later time within 4 business hours of your appointment you will be charged a $35 cancellation fee. If you miss your "Rescan" appointment and do not provide at least 4 hours notice you will be charged $35 for the "Rescan" appointment.

- Upgrades to packages made from the checkin-in form are subject to availablity.

- Images and video taken by Tummy Vision may be used for advertising and marketing purposes including social media. Client names and any personal information will be removed from the pictures or video for confidentiality.

-Any items purchased or obtained via giveaway from Tummy Vision are meant for entertainment and should not be used by children. Tummy Vision is not responsible for any injury, harm or damages caused by items. We do not accept returns on heartbeat animals, clothes or shoes.

- This waiver will apply to any future appointments with the same pregnancy including rescans/redo appointments.

As evidenced by your signature below, you understand that factors beyond our control may also affect the ability toaccurately determine the gender of the fetus, and that Tummy Vision Ultrasound Studio can provide no warranty or guarantyas to the accuracyof any such determination.You further understand that while ultrasound is believed to have no harmfuleffect on the mother or the fetus, future research or other information may discloseharmful oradverse effects that are presently unknown.

IN CONSlDERATIONOF THE SERVICESRENDERED,YOU AGREETO RELEASETummy Vision Ultrasound Studio,ITS AGENTS; AFFILIATES, DIRECTORS, AND EMPLOYEES FROM ANY AND ALL CLAIMS OR CAUSES OF ACTIONS FOR INJURY, HARM, DAMAGE OR OTHER LIABILITY WHICH RESULTS FROM, OR ARE ALLEGED TO HAVE RESULTED FROM, THIS ULTRASOUND, INCLUDING, BUT NOT LIMITED TO, THE FAILURE OF Tummy Vision Ultrasound Studio TO ACCURATLEY DETERMINE FETAL GENDER OR OTHER CHARACTERISTICS, AND ANY DAMAGES OR INJURIES RESULTING FROM ULTRASOUND WHICH ARE NOT NOW KNOWN TO OCCUR.

I have carefully read this document and by signing at the bottom,acknowledge that I fully understand and agree to its contents.