1. Prenatal Care: I acknowledge and understand that prenatal care is important to a healthy pregnancy. I am currently receiving prenatal care from a licensed healthcare professional. Upon recommendation of my physician, I am consenting to an ultrasound in order to obtain additional information for my healthcare professional team. I understand that the benefit of this exam is to assist my physician with making a diagnosis.

2. Concerns Referred to Physician: I understand I am responsible for contacting my healthcare provider if any questions or concerns arise regarding any issues relating to this ultrasound session or any aspect of my pregnancy. I have also been informed that New Beginnings Imaging & Consulting LLC’s services cannot substitute for the care of a physician.

3. No Professional Negligence Claims: I understand that New Beginnings Imaging & Consulting LLC will work with a third-party radiologist to receive an interpretation of the ultrasound imaging and that New Beginnings Imaging & Consulting LLC is not responsible for any errors with regards to such interpretations. New Beginnings Imaging & Consulting LLC shall have no duty or legal obligation to diagnose, or attempt to diagnose, any condition that may be observed by generating an image or picture. I agree that I have no right to recourse against New Beginnings Imaging & Consulting LLC for any medical-malpractice, professional negligence, or any medical related claim arising out of, or in any way, related to my pregnancy, this ultrasound, or the birth of my child. This includes any claim for error in gender identification.

4. FDA Compliance: I understand and acknowledge that New Beginnings Imaging & Consulting LLC follows Federal Drug Administration (FDA) recommendations for length of scan and frequency of ultrasound waves, and I consent to the administration of the ultrasound in compliance with these recommendations.  

5. Waiver and Release of Claims: An ultrasound is not a definite test for the existence or non-existence of fetal abnormalities. Despite normal imaging and interpretation of the test, some babies may be born with abnormalities not identified by the radiologist during the examination of the imaging. Thus, while I understand that an ultrasound is a very helpful diagnostic tool, I acknowledge that it cannot be absolute proof of the absence or existence of fetal defects. As such, I hereby waive, release, acquit, indemnify, hold harmless, and forever discharge New Beginnings Imaging & Consulting LLC, and all of New Beginnings Imaging & Consulting LLC’s Third-Party Contractors from any and all injuries, damages, claims, expenses, demands, costs, causes of action, and all other actions and liabilities, of any nature whatsoever, whether caused by the negligence of the released parties or otherwise, whether known or unknown, and whether in the law or equity, that I, my baby, or any others may have, arising out of or in any way related to the ultrasound and other services provided by New Beginnings Imaging & Consulting LLC or its Third-Party Contractors.

6. Defined Term: As defined in this document “New Beginnings Imaging & Consulting LLC” shall include New Beginnings Imaging & Consulting LLC, its owners, officers, agents, employees, independent contractors, attorneys, and any affiliated entities. As defined in this document “Third-Party Contractors” shall include the owners, officers, agents, employees, independent contractors, attorneys, and any affiliated entities of any and all third-party contractors that New Beginnings Imaging & Consulting LLC deals with throughout the course of this engagement.

7. Photo Release: I hereby give New Beginnings Imaging & Consulting LLC permission to post or use any and all photos, information, and recorded data for advertisement or other purposes. New Beginnings Imaging & Consulting LLC has my permission to video and photograph my baby, me, and others present during the services provided and it has full editing and publishing rights to the media.

8. Picture Quality: I understand that the quality of ultrasound imaging is dependent on a number of factors, including but not limited to, developmental stage, fetal position, fetal cooperation, amniotic fluid levels, and maternal body size. I understand that New Beginnings Imaging & Consulting LLC cannot guarantee satisfactory baby position, picture quality, or picture clarity. I understand that no refunds are available under any circumstance and that it is my sole obligation to pay for these services. I further understand that picture quality may affect the opinion of the radiologist, and if I am unhappy with the results for any reason, my recourse shall be to seek additional diagnostic ultrasound(s), and/or any other tests or treatments that have been, or may be, recommended by my healthcare provider

9. Consent to Share Information with other Professionals. I give New Beginnings Imaging & Consulting LLC consent to share information regarding me and my ultrasound with other related professionals, including but not limited to: physicians, radiologists, midwives, therapists, Third-Party Contractors, health insurance agents, etc. I understand that if I wish to rescind this consent at a future date, I will do so in writing to New Beginnings Imaging & Consulting LLC.

10. Entire Agreement: This Agreement contains and constitutes the entire agreement regarding the subject matter hereof and supersedes any and all prior agreements, understandings, and discussions between the undersigned and New Beginnings Imaging & Consulting LLC. The section and other headings contained in this Agreement are for reference purposes only and shall not affect the meaning or interpretation of this Agreement.  This Agreement shall be entered into in the state of North Dakota and North Dakota law shall govern its application and interpretation. Venue for any dispute arising from, or related to, this Agreement shall be proper only in Ward County, North Dakota.

11. No Oral Modification: I agree that no modification of this Agreement shall be valid unless made by a written amendment that is signed by both the client and an authorized agent of New Beginnings Imaging & Consulting LLC.

I HAVE READ, UNDERSTAND, AND AGREE TO ALL OF THE ABOVE PROVISIONS, I GIVE MY CONSENT TO THIS ULTRASOUND AND RELATED SERVICES, AND HAVE SET MY HAND HERETO AS OF THE DATE LISTED BELOW.

*If you prefer to keep your ultrasound images private until you're ready to share the news, please inform us. We prioritize your comfort and privacy above all else.