Forms

Welcome! Before we begin, we want to ensure that you have all the necessary information regarding our liability waiver. Your safety and understanding are our top priorities. Please take a moment to review and acknowledge the terms outlined in our waiver, which will help ensure a secure and enjoyable experience with us. We appreciate your cooperation and look forward to serving you.

Sneak A Peek

Liability Waiver

Please fill out the following form in order to participate.

First name

Last name

Due Date

Have you been hospitalized in the last 12 months?

Yes

Are you suffering from a medical condition, illness, or injury?

Yes

If you answered yes to any question, please elaborate

I declare that the info I’ve provided is accurate & complete

Phone

Prenatal Care; I acknawlodge that I have been informed by Sneak A Peek Ultrasound & Spa that prenatal care is important to a healthy pregnancy. I am currently receiving prenatal care and my doctor has been informed and has no objections to me attending this sonography session. Concerns should be referred to Physician: I have also been informed by Sneak a PeekUltrasound & Spa that use of Sneak a PeekUltrasound & Spa services cannot substitute for care of a physician. If I have any concerns regarding my pregnancy, I will contact my doctor. I will in no way rely upon Sneak a Peek Ultrasound & Spa or its services for medical advice. No Professional Negligence Claims: I am purchasing Sneak a Peek Ultrasound & Spa services and products for keepsake, non-medical purposes.I agree that I have no right to recourse against Sneak a Peek Ultrasound & Spa in any medical malpractice, professional negligence, or any medical related claim arising out of or in any way related to my pregnancy or the birth of my child. This includes any claim for error in gender determination. Assumption of Risks: I acknowledge that there is inherent risk in any activity involving a fetus and there are potential risks in this type of activity. I understand Sneak a Peek Ultrasound & Spa follows FDA recommendations for length of scan and frequency of ultrasound waves ,and that no detrimental effects have been found in 40 years of studies. I hereby voluntarily assume all risk of harm or injury to me ormy baby resulting from the services provided by Sneak a Peek Ultrasound & Spa. Waiver and Release of Claims: I hereby waive, release, acquit and forever discharge Sneak a Peek Ultrasound & Spa from any and all claim expenses, demands, costs, cause of actions, and other actions and liabilities, of any nature what so ever, whether known or unknown ,whether in law or equity, that I or my baby may have arising out of or in any way related to my visit to Sneak a Peek Ultrasound & Spa. I agree that I shall have no right what so ever to file any lawsuit or institute any other action or legal proceedings of any type arising out of or in anyway related to my visit to Sneak a Peek Ultrasound & Spa. Photo Release: I give Sneak a Peek Ultrasound & Spa permission to post or use any photos or recorded data for advertisement purposes. I understand no names will be posted or used with the photos. Picture Quality: I understand picture quality is dependent on many factors. I understand that Sneak a Peek Ultrasound & Spa is not always able to obtain pictures of every baby. I understand NO refunds are available if unable to obtain pictures or gender. I have notified my physician that I have chosen to obtain an elective fetal ultrasound and other services from Sneak a Peek Ultrasound & Spa & I understand my physician has not ordered this. I understand that this ultrasound is not to be used to replace physician care. I have been informed that Sneak A Peek Ultrasound & Spa follows FDA recommendations for frequency (sound waves) and length of scan which has found no detrimental effects in 40 years of case studies.I HAVE READ AND UNDERSTAND ALL OF THE ABOVE. I AGREE TO ALL OF THE ABOVE.

I accept terms & conditions

Your Signature

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Thanks for submitting!

Get Zapped

Liability Waiver

Please fill out the following form in order to participate.

First name

Last name

Have you been hospitalized in the last 12 months?

Yes

Are you suffering from a medical condition, illness, or injury?

Yes

If you answered yes to any question, please elaborate

I declare that the info I’ve provided is accurate & complete

Phone

I acknowledge that the process of permanent jewelry involves a micro (arc) welding machine that emits a bright flash and possible spark. While any burning or injury to the skin or eye damage is unlikely, Get Zapped/Sneak A Peek Ultrasound & Spa will be held harmless in the event of an injury.I acknowledge that Get Zapped/Sneak A Peek Ultrasound & Spa offers 14k gold, gold filled and sterling silver (all nickel and lead free), which are all considered hypoallergenic metals.Get Zapped/Sneak A Peek Ultrasound & Spa is not responsible for the rare occurrence of an allergic reaction or skin irritation.I acknowledge that while the jewelry is permanent, it is not indestructible. A reasonable amount of care is required to maintain the integrity of the jewelry. In the event of an emergency, event (such as an MRI), or the jewelry is no longer desired, it can simply be cut off with a good pair of scissors or wire cutters.I acknowledge that all sales are final due to the custom nature of the permanent jewelry. Should a piece of jewelry break at the weld site within 14 days of the initial weld, I will contact Get Zapped/Sneak A Peek Ultrasound & Spa within that time frame to coordinate a free re-weld. Must have original chain!

Jewelry can be removed by cutting the attaching ring with scissors, fingernail clippers, or other small cutting device.Travelers are not required to remove real gold or silver jewelry for security screening. Costume jewelry, however, may trigger the alarm due to it's magnetic metals.Jewelry can be cleaned with warm water, a soft toothbrush, and dish soap or jewelry cleaning wipes.Silver is prone to oxidation in certain conditions, such as exposure to hot tub chemicals, chlorine, cleaning chemicals, humidity, or your PH levels. An indicator of oxidation is a blackening of the jewelry. If this occurs, use a silver cleaner or silver cleaning wipe to restore your jewelry to it's previous condition.If your jump ring must be cut to remove your jewelry for a medical procedure,Get Zapped/Sneak A Peek will reattach free of charge. If your permanent jewelry was placed by another provider, a $10 fee wil be assessed.

I accept terms & conditions

Your Signature

Select a date

Thanks for submitting!

Form Submission and Acknowledgment

Thank you for completing the form and acknowledging our terms. Your submission is important to us, and we value your commitment to safety and compliance. If you have any further questions or require assistance, please don't hesitate to contact us. We appreciate your trust and look forward to serving you.

Forms

Sneak A Peek

Liability Waiver

Get Zapped

Liability Waiver

Form Submission and Acknowledgment

Contact Us

614-551-7619

5524 Hilliard Rome Office Park

Forms

Sneak A Peek Liability Waiver

Get Zapped Liability Waiver

Form Submission and Acknowledgment

Contact Us

614-551-7619

5524 Hilliard Rome Office Park

Sneak A Peek

Liability Waiver

Get Zapped

Liability Waiver