Acknowledgement & Consent
2. Indemnity
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BY BOOKING AN ULTRASOUND YOU CONFIRM YOU HAVE READ, UNDERSTOOD AND ACCEPT THE BELOW AND AGREE TO BE BOUND THEREBY
ACKNOWLEDGEMENT & CONSENT AGREEMENT
I (“the Customer”) HEREBY ACKNOWLEDGE having been advised by PEEKABOO ENTERPRISES PTY LTD ABN 84 601 063 861, trading as “Hello Baby 3D” (the “Service Provider”) and agree with the Service Provider as follows:
The Service Provider offers to perform an elective 2D, 3D, and 4D ultrasound on myself and any child or children in utero (“my Child”) at the Service Provider’s premises (“the Service”).
The Service is not performed for any medical reason and is not provided for or performed for the purpose of diagnosing any medical condition whether with respect to myself or my Child.
The Service does not detect chromosomal, structural or obstetric abnormalities.
The Service is provided to me solely for the purpose of providing me with photographic ultrasound images or a video (or both) of my Child.
Any image and video provided to me as part of the Service may vary in the quality due to various contributing factors that may be present at the time the Service is provided included, without being limited thereto: a.) the position of my Child in the womb b.) the placenta location c.) the amount of amniotic fluid present d.) my physical stature e.) my body mass.
The Service Provider cannot give me any warranty or guarantee as to the quality of any image or video provided to me as part of the Service.
Prior to my requesting the Service, all medical issues surrounding the Service have been discussed by me with my physician or doctor (or both) under whose care I presently am.
The person engaged by the Service Provider to provide the Service to me on its behalf is not and will not be medically trained or qualified to any extent at all and is not required to be so qualified in order to provide the Service by utilisation and the operation of the ultrasound machine to be used in the course of having the Service provided to me.
No suggestion, inference, reference or comment whatsoever made by any person providing the Service to me on behalf of the Service Provider constitutes medical advice.
My entry into the Service Provider’s premises for the purpose of having the Service Provider provide the Service is of my own volition and voluntary and with full knowledge that I can leave at any time I desire.
Prior to engaging the Service Provider to provide the Service I had the opportunity to make any enquiry regarding the Service that I considered appropriate and to the extent that I made any such enquiry I was satisfied with the response received.
The Service Provider does not hold out that the Service is covered by any medical insurance policy and does not expect any contribution towards the cost of having the Service provided will be paid to me by any medical insurer. To the extent that any such insurer does determine to make that contribution then it will be my responsibility to obtain payment thereof. The Service Provider need make no reduction in the fee payable by me to it commensurate with that contribution.
I must pay the Service Provider for the Service prior to the Service being provided.
If I am not satisfied with the Service provided then subject to the relative Consumer Law to the contrary, no refund or repeat of the Service will be made by or on behalf of the Service Provider unless it, in its absolute and sole discretion, determines otherwise.
I am physically fit and have satisfied myself that the provision of the Service by the Service Provider to me at my request will not in any way harm myself or my Child.
The Service Provider will have the free and unfettered use of the photographs resulting from the provision of the Service to me to be utilised for such advertising purposes, including on websites available from time to time, for example, but without being limited thereto, “Facebook”, or such other medium as may be available from time to time to the Service Provider for that purpose.
To adhere to instructions and conditions as may be given or imposed by the Service Provider in relation to its provision of the Service to me.
I must follow the instructions of the Service Provider and of each of its respective officers, employees, contractors or agents (the “Personnel”) in the course of the Service being provided to me.
The Service Provider may, in its sole and absolute discretion, reject or cancel the provision of the Service at any time, including, without limitation, for safety or insurance reasons.
Should the provision of the Service be cancelled by me or if I do not present at the prearranged place and time for the provision of the Service I will not subject to the relevant Consumer Law and the Service Provider’s decision to do otherwise, be entitled to a refund of any monies previously paid by me to the Service Provider and no liability will attach to the Service Provider in relation to those monies.
I consent to receive and agree to pay for any medical treatment (including transfer by ambulance) which is reasonably considered necessary in the reasonable opinion of the Service Provider or any of its Personnel or other person whatsoever to be advisable at any time during the course of the provision of the Service.
My attendance upon the Service Provider is for the purpose of having the Service provided to me at my own risk.
The Service Provider does not guarantee the accuracy of any results achieved from the provision of the Service.
The Service Provider, nor any of its Personnel, holds any medical qualification and that the Service is not a medical procedure.
I freely agree to participate in the provision of the Service to me as requested by me.
I have read, understood and accept the above and agree to be bound thereby.
INDEMNITY
I (“the Customer”) HEREBY: Waive, release, discharge, indemnify and save harmless (and will hereafter continue so to do) PEEKABOO ENTERPRISES PTY LTD ABN 84 601 063 861, trading as “Hello Baby 3D” (the “Service Provider”) and each of its respective officers, employees, contractors or agents (the “Personnel”) in any way involved in the provision of the elective 2D, 3D, and 4D ultrasound on myself and any child or children in utero (“my Child”) in my preferred location (“the Service”) to me from all claims and from all causes of action (including any settlement, ex-gratia payments made with the consent of the parties to and reasonable legal and expert costs and expenses) including for negligence, made or brought by or on my behalf (including any child or children injured in utero through my participation in having the Service Provider provide the Service) against the Service Provider or any one or more of its Personnel (or both) for personal injury (including death) to me (or any child or children injured in utero through my participation in having the Service Provider provide the Service) or damage to my property, and including any consequential loss or damage resulting therefrom including, but without being limited thereto, that resulting from any advice provided by the Service Provider to me as to the gender of any said child or children of mine, relating to or arising out of the provision of the Service to me by the Service Provider including the use of the ultrasound machine (including any attachment or part thereto or thereof).
I have read, understood and accept the above and agree to be bound thereby.