Dear Doctor:

Your patient is interested in having an ultrasound session that combines 2D,3D, and 4D at Stork Studios for the purposes of family bonding.

This letter is to request your permission for such a scan. Stork Studios is owned and operated by Dr. Virginia Elgin. She is a child neurologist, board certified in adult and child neurology as well as pediatrics.

Professional sonographers perform the scans and no one is scanned unless they can provide Stork Studios with information that would ensure they are receiving prenatal care. We request that the following information be provided:

Name of Client:

Name, Address, and Phone Number of OB GYN:

Date of Last Visit:

Your signature below indicates you give permission for your patient to have the scan. In the unlikely event we believe we find something wrong, we will make every effort to contact you. Thank you, and feel free to contact us with any questions.