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Get Whole Woman's Health Ultrasound Consent 2011-2024

I understand the information described above and by signing this form give my consent to undergo ultrasound examination. Patient Signature Date Witness Date AF Oct. Whole Woman s Health Ultrasound Consent An ultrasound or sonogram involves the transmission of sound waves reflected off your uterus and fetus which are monitored and recorded digitally to obtain information concerning your pregnancy. This test is believed to carry very little risk to you or the fetus baby. The standard ultrasound exam takes approximately 10 to 30 minutes to perform and may provide information concerning placental location fetal position multiple gestations twins etc* approximate gestational age and possible presence of certain gross fetal malformations. Whole Woman s Health does not offer diagnostic ultrasound services to determine the health of the fetus or the pregnant woman or to diagnose other issues in the pelvic area such as cysts or fibroids. This test is believed to carry very little risk to you or the fetus baby. The standard ultrasound exam takes approximately 10 to 30 minutes to perform and may provide information concerning placental location fetal position multiple gestations twins etc* approximate gestational age and possible presence of certain gross fetal malformations. Whole Woman s Health does not offer diagnostic ultrasound services to determine the health of the fetus or the pregnant woman or to diagnose other issues in the pelvic area such as cysts or fibroids. .

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