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Baby Scans 4D

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  • Home
  • Scans
    • Watch Me Grow Scan
    • 4D Scan
    • Gender Scan
    • Early Pregnancy Scan
  • Extras
  • About
  • Gallery
  • FAQs
  • Health Tips
    • Excercise
    • Emotional Wellbeing
    • Healthy Eating
    • Smoking Cessation
  • Contact

Pregnancy Scan Consent Form

4D Scan Disclaimer

BABY SCANS 4D aim to provide each client with a unique experience by excelling your expectations of any 4D Bonding scan. Your scan today will be performed by an Ultrasound Technician with a wealth of experience that will immediately put you and your family at ease. A transabdominal probe will be used during your scan and glides over the stomach. There are some restrictions to obtaining clear images and occasionally no images of the baby’s face. These are listed below. You are welcome to bring friends and family to your appointment, if you require support we can provide you with a certified chaperone on the day, our receptionist can assist you.

The potential reasons for restricted view.

  • Raised BMI over 35
  • Fetal position
  • Pain/Guarding of the abdomen
  • Bowel Gas/Some bowel conditions

We have produced an information folder called ‘Patient Information and Safety of Ultrasound’ for you to review. This is located in reception- alternatively please ask a member of staff to assist you

As a client of Baby Scans 4d your privacy will be protected, and we support any friends or family to accompany you. Verbal consent will be asked prior to any scan. If at any point you feel uncomfortable or wish to end your scan, please inform your Ultrasound Technician immediately.

The safeguarding of our clients is paramount, and we continually assess your needs and safety. We abide by our rigorous risk assessments to ensure our duty of care follows local and national guidance in relation to safeguarding. Our safeguarding lead is Louise Wicks Gemmell who can be contacted on 0116 289 5987, or our staff are happy to assist you with any concerns

Our services are non-diagnostic, and Baby Scans 4d will not be confirming or determining any pregnancy related or fetal conditions, if Ultrasound Technicians consider a hospital referral necessary we do refer clients to a hospital of choice for further scans and professional opinion. Any such scenario will be discussed at length, consent obtained, scan information provided and a 24-hour helpline to contact if further support be required prior to any appointment.

By signing your consent for you are confirming you have read and understood the above and consent to BABY SCANS 4D conducting a 2D/ 4D HD Live Bonding scan during your appointment.

Consent(Required)

Watch Me Grow Scan Disclaimer

Baby Scans 4d aim to provide each client with a unique experience by excelling your expectations of your non-Diagnostic Watch me Grow Scan. Your scan today will be performed by a Ultrasound Technicians with a wealth of experience that will immediately put you and your family at ease. A transabdominal probe will be used during your scan and glides over the stomach. There are some restrictions to obtaining clear images and occasionally this may inhibit obtaining clear views during your scan- Your Ultrasound Technician will discuss further is this is an issue. Potential issues are listed below.

You are welcome to bring friends and family to your appointment, if you require support we can provide you with a certified chaperone on the day, our receptionist can assist you.

The potential reasons for restricted view.

  • Raised BMI over 35
  • Tilted/Malformations of the uterus
  • Pain/Guarding of the abdomen
  • Bowel Gas/some bowel conditions

We have produced an information folder called ‘Patient information and Safety of Ultrasound’ for you to review if you wish.
This can be located in reception- alternatively please ask a member of staff to assist you.

As a client of Baby Scans 4d your privacy will be protected, and we support any friends or family to accompany you. Verbal consent will be asked prior to any scan. If at any point you feel uncomfortable or wish to end your scan, please inform your Ultrasound Technician immediately.

The safeguarding of our clients is paramount, and we continually assess your needs and safety. We abide by our rigorous risk assessments to ensure our duty of care follows local and national guidance in relation to safeguarding. Our safeguarding lead is Louise Wicks Gemmell who can be contacted on 0116 289 5987, or our staff are happy to assist you with any concerns

Our services are non-diagnostic, and Baby Scans 4d will not be confirming or determining any pregnancy related or fetal conditions, if Ultrasound Technicians consider a hospital referral necessary we do refer clients to a hospital of choice for further scans and professional opinion. Any such scenario will be discussed at length, consent obtained, scan information provided and a 24-hour helpline to contact if further support be required prior to any appointment.

By signing your consent form, you are confirming you have read and understood the above and consent to BABY SCANS 4D conducting an 2D/4D Watch Me Grow Scan during your appointment.

Consent(Required)

Gender Scan Disclaimer

Baby Scans 4d aim to provide each client with a unique experience by excelling your expectations of your non-Diagnostic Gender Scan. Your scan today will be performed by an Ultrasound Technicians with a wealth of experience that will immediately put you and your family at ease, offering a 99.9% opinion of your baby’s gender. A transabdominal probe will be used during your scan and glides over the stomach. There are some restrictions to obtaining clear images and occasionally this may inhibit obtaining clear views during your scan- Your Ultrasound Technician will discuss further is this is an issue. Potential issues are listed below.

You are welcome to bring friends and family to your appointment, if you require support we can provide you with a certified chaperone on the day, our receptionist can assist you.

The potential reasons for restricted view.

  • Raised BMI over 35
  • Tilted/Malformations of the uterus
  • Pain/Guarding of the abdomen
  • Bowel Gas/Some bowel conditions

We have produced an information folder called ‘Patient information and Safety of Ultrasound’ for you to review. This can be located in reception- alternatively please ask a member of staff to assist you.

As a client of Baby Scans 4d your privacy will be protected, and we support any friends or family to accompany you. Verbal consent will be asked prior to any scan. If at any point you feel uncomfortable or wish to end your scan, please inform your Ultrasound Technician immediately.

The safeguarding of our clients is paramount, and we continually assess your needs and safety. We abide by our rigorous risk assessments to ensure our duty of care follows local and national guidance in relation to safeguarding. Our safeguarding lead is Louise Wicks Gemmell who can be contacted on 0116 289 5987, or our staff are happy to assist you with any concerns

Our services are non-diagnostic, and Baby Scans 4d will not be confirming or determining any pregnancy related or fetal conditions, if Ultrasound Technicians consider a hospital referral necessary we do refer clients to a hospital of choice for further scans and professional opinion. Any such scenario will be discussed at length, consent obtained, scan information provided and a 24-hour helpline to contact if further support be required prior to any appointment.

By signing your consent form, you are confirming you have read and understood the above and consent to BABY SCANS 4D conducting a 2d/4d gender scan during your appointment.

Consent(Required)

Early Pregnancy Scan Disclaimer

BABY SCANS 4D aim to provide each client with a unique experience by excelling your expectations of an early pregnancy scan. We always recommend early pregnancy scans to be conducted from 6 weeks of pregnancy which is generally 2 weeks post your missed period date. For the appointment you will require a comfortable full bladder.

You are welcome to bring friends and family to your appointment, if you require support we can provide you with a certified chaperone on the day, our receptionist can assist you.

A trans-abdominal scan is conducted by scanning via a probe over your stomach. Generally, we anticipate any pregnancy over 6 weeks can be visualised via a trans-abdominal scan. There are restrictions that can inhibit this, and they are detailed below.

The potential reasons for restricted view.

  • BMI over 35
  • Tilted and or malformations of the uterus
  • Pain / guarding of the abdomen
  • Bowel gas / some bowel conditions

We have produced an information folder called ‘Patient Information & Safety of Ultrasound’ for you to review.
This can be located in reception- alternatively please ask a member of staff to assist you.

As a client of BABY SCANS 4D your privacy will be protected, and we support any friends or family to accompany you. Verbal consent will be asked prior to any procedure. If at any point you feel uncomfortable or wish to end your scan, please inform your Ultrasound Technician immediately.

The safeguarding of our clients is paramount, and we continually assess your needs and safety. We abide by our rigorous risk assessments to ensure our duty of care follows local and national guidance in relation to safeguarding. Our safeguarding lead is Louise Wicks Gemmell who can be contacted on 0116 289 5987, or our staff are happy to assist you with any concerns

Our services are non-diagnostic, and Baby Scans 4d will not be confirming or determining any pregnancy related or fetal conditions, if Ultrasound Technicians consider a hospital referral necessary we do refer clients to a hospital of choice for further scans and professional opinion. Any such scenario will be discussed at length, consent obtained, scan information provided and a 24-hour helpline to contact if further support be required prior to any appointment.

By signing your consent form you are confirming you have read and understood the above and consent to BABY SCANS 4D conducting an early pregnancy scan during your appointment.

Consent(Required)

Name And Address Details

Name(Required)
Address(Required)
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Medical Information

Doctor's Name
Surgery Address

Emergency Contact

Please provide the name and contact details for an individual we can contact in the event of an emergency.
Name
Does anyone in your life make you feel scared or unsafe?
If someone threatens you, controls what you can do or pressures you into doing things, this is not ok. You have a right to safety.
Please note that in certain circumstances , we may be legally obligated to share information with relevant authorities if we believe or you disclose you or another person may be in immediate danger. Baby Scans 4d support our clients and their families to feel safe and free from danger and or harm.

Demographic Info

To enable Baby Scans 4d to understand the demographics of our service users and potentially identify inequalities or areas where positive action might be needed, we ask clients to consider answering the following questions. Your answers are not compulsory and you may opt out of answering.
If yes, please indicate the type of disability/condition (select all that apply):
Please provide details of any other condition
Please provide details of any other condition
Please provide details of any other condition
Please provide details of any other condition
  • Baby Scans 4D take client confidentiality and privacy extremely seriously and Baby Scans 4D will follow all policies and procedures in line with GDPR guidelines.
  • Paper signed consent forms will be kept in a locked filing cabinet in a secure place for 12 months
  • After 12 months all digital and paper signed consent forms will be securely disposed
  • All personal information will only be stored on our secure computer system if you wish to receive marketing material relating to offers – newsletter and competitions.
Marketing Consent
Preferred Communication Method

Early Pregnancy Scans are conducted from 6 weeks of pregnancy. The number of weeks will determine the best approach to view the necessary structures and provide reassurance.

If you are below the 6-week mark once the ultrasound technician has scanned you, you will be offered a rescan within 2 weeks at a discounted price of £20.

If you have any concerns, please inform the receptionist.

Clear Signature
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Contact Details

Baby Scans 4D
1 The Parade
Needham Avenue
Glen Parva
Leicester
LE2 9JW

info@babyscans4d.co.uk

0116 289 5987

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