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The document is a Prenatal Care Verification Report and Patient Consent Form for Baby Pictures Ultrasound, allowing a patient to receive a 2D or 3D/4D ultrasound. It includes sections for the healthcare provider's approval and the patient's consent to release medical information to the ultrasound facility.

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Click ‘Get Form’ to open it in the editor.
In the first section, enter the patient's name where indicated. This is crucial for identifying the individual receiving the ultrasound.
Next, locate the provider's information section. Here, print the provider's name and date clearly to ensure proper documentation.
Proceed to sign and date in the designated areas. This confirms consent and approval for the ultrasound procedure.
In the patient consent section, fill in your name and date again. Sign where required to authorize information release.
Finally, review all entries for accuracy before saving or sending your completed form directly from our platform.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can you ask for a copy of your ultrasound?

Under the HIPAA Privacy Rule, patients have a right to access their images from screening and diagnostic tests and procedures in the form and format they request, so long as the covered entity can readily produce them.

Do ultrasounds have names?

Ultrasound (also called sonography or ultrasonography) is a noninvasive imaging test. An ultrasound picture is called a sonogram. Ultrasound uses high-frequency sound waves to create real-time pictures or video of internal organs or other soft tissues, such as blood vessels.

Does an ultrasound have your name on it?

Spotting a Ultrasound: Key Indicators Real ultrasounds include details like the patients name, date, and the medical facility where the procedure took place. Therefore, be wary of images that lack these vital labels or display conflicting information.

Can you record your ultrasound on your phone?

A: Unfortunately, no we do not allow recording during ultrasounds. Sonography is a very technical procedure; the sonographer needs to focus on you and your baby. We ask that all cell phones and video devices be turned off during the exam.

Can I get an ultrasound without a referral?

You cannot get a diagnostic ultrasound without a referral. You can can go to a private clinic and pay out of pocket whenever you like. A place like ucbaby, etc.

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Can I do an ultrasound on my phone?

Enter POCUS (Point of Care Ultrasound). This small, handheld probe allows doctors to see ultrasound scans on a tablet or cellphone. In November 2021, the Spencer Fox Eccles School of Medicine at the University of Utah became one of only four medical schools in the U.S. with these devices.

What information goes on an ultrasound?

An ultrasound scan uses high-frequency sound waves to make an image of a persons internal body structures. Doctors commonly use ultrasound to study a developing fetus (unborn baby), a persons abdominal and pelvic organs, muscles and tendons, or their heart and blood vessels.

What is written on an ultrasound?

The top of an ultrasound image usually shows a series of numbers and other information. Ultrasound centers and hospitals tend to use this space for details such as: Patient name. Hospital reference number. Ultrasound machine settings.

Put your name on an ultrasound online 2025

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How to use or fill out put your name on an ultrasound online with our platform

Complete this form in 5 minutes or less

Got questions?

Can you ask for a copy of your ultrasound?

Do ultrasounds have names?

Does an ultrasound have your name on it?

Can you record your ultrasound on your phone?

Can I get an ultrasound without a referral?

Complete this form in 5 minutes or less

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Can I do an ultrasound on my phone?

What information goes on an ultrasound?

What is written on an ultrasound?

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