Registration - MOMentum

Thank you for allowing us to be a part of this wonderful time in your life.
Enjoy your images.

Registration Form

I have read and agree to the terms of service
Terms:
By checking the ‘I have read and agree to the terms of service’ box prior to reviewing your images, for the purposes of HIPAA notification, you have authorized your OBGYN practice and MOMentum to send your ultrasound images to you at the email address you provided the practice. You also agree that you hold the practice/sender and MOMentum harmless for your use of any of the image you receive from this site and for your use of your images in any electronic or printed format or environment. You also understand and agree that the ultrasound images you receive are in a non-diagnostic image format and are to be use strictly for your personal use and entertainment. If you modify your images in any way, you understand that you may be including patient health information and that you accept responsibility for the information that you share on and with these images. Other uses and disclosures of your images that may contain personal health information will be made only with your written authorization, unless permitted/required by law as described below. You may revoke this authorization, at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the authorization.
We value your privacy. None of your information is shared:
Privacy Policy
8-digit Authorization Code