Sonogram Request Form

A sonogram may be used to confirm your pregnancy. In order to receive a free sonogram at one of our centers you will need either written proof of a positive pregnancy test from your doctor or a positive pregnancy test taken in one of our centers, free of charge. Once you have completed this form you will be contacted about your request.

Typing your name here gives us permission to call you.
We care about your privacy. Please let us know if we may leave a message on your voicemail or answering machine saying we are calling from Care Net.
Please bring your proof of pregnancy with you to your sonogram appointment.

Thank you for completing this form.  Our Nurse Manager will contact you about an appointment.