3D4D Ultrasound Non-Diagnostic Waiver and Informed Consent

I agree to allow Claire Smith ABN 50848012696 trading as Miracle Beginnings to perform a non-diagnostic ultrasound on my baby using an ultrasound machine.

I agree and acknowledge that:

To the extent permitted by law, I hereby agree, for myself and my unborn baby and our respective assignees, heirs, guardians, and legal representatives:

Claims:
That we will not make a claim against Miracle Beginnings 3D4D Ultrasound, or any of its stakeholders for damages resulting from or arising out of the creation of the ultrasound images whether it be directly or indirectly. To release Miracle Beginnings 3D4D ultrasound from all actions, claims or demands that we may now have or may have for injury or damage resulting from participating in the process of creating these ultrasound images. That the total liability of Miracle Beginnings 3D/4D ultrasound and its stake holders is limited to the price paid by the you/ the “customer” for the service which is the basis of the claim to the maximum extent permissible by law.

No Professional Negligence Claims:
I am purchasing Miracle Beginnings services and products for keepsake, non-medical purposes. I agree that I have no right to recourse against Miracle Beginnings 3D4D Ultrasound in any medical malpractice, professional negligence or any medical related claim arising out of or in any way related to the pregnancy or the birth of the child.

Assumptions of risk:
I acknowledge that there is inherent risk in any activity involving a foetus and there are potential risks in this type of activity. I understand that Miracle Beginnings 3D4D Ultrasound follows FDA recommendations for length of scan and frequency of ultrasound sound waves, and that no detrimental risks have been found in 40 years of study. I hereby voluntarily assume all risks of harm or injury to yourself/ the “customer” or the baby resulting from services provided by Miracle Beginnings 3D4D Ultrasound.

Waiver and Release of Claims:
I hereby waive, release, acquit and forever discharge Miracle Beginnings 3D4D Ultrasound 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 arisen out of or in any way related to my visit to Miracle Beginnings 3D4D Ultrasound. I agree that I shall have no right whatsoever to file a lawsuit or institute any other action or legal proceedings of any type arising out of or in any way related to the visit to Miracle Beginnings 3D4D Ultrasound.

I have carefully read this consent form and waiver and fully understand the contents above.

CONSENT FORM