Treasured Begnnings Application

Please fill out the following form.

First name

Last name

Email*

Estimated due date

Are you currently uninsured?

Yes

Are you a single parent?

Yes

Are you currently experiencing financial hardship?

Yes

Are you 21 years old or younger?

Yes

Please briefly tell us why you're requesting assistance. This information helps us understand your needs and determine how we can best help.

*Assistance is limited and awarded based on available funding and program availability. Completing an application does not guarantee approval.

I declare that the info I’ve provided is accurate and complete.

Treasured 3D Ultrasound offers elective, non-diagnostic ultrasound experiences for keepsake and bonding purposes only. We are not a medical provider and do not provide medical advice, diagnosis, or medical imaging services.*

Agree

Our services do not replace prenatal care from a qualified healthcare professional.*

Agree

Treasured 3D Ultrasound is not responsible for medical decisions, outcomes, complications, or events that occur before, during, or after your appointment. *

Agree

Any medical concerns, questions, or symptoms should be directed to your healthcare provider.*

Agree

By participating in services provided by Treasured 3D Ultrasound, you acknowledge and understand that these services are elective in nature and are not performed for medical evaluation or diagnosis. *

Agree

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