Client Forms

Use the menu below to download forms to fill out and bring to your thermography appointment.

All Clients
Patient Information Form
Patient Authorization Form
Patient Consent Form
Patient Privacy Form

Breast Scan Only
Breast Thermogram Form
Form for Patients with a History of Breast Disease or Treatment

Full Body Scan With Breast
Full Body Thermogram Information Form
Breast Thermogram Form
Form for Patients with a History of Breast Disease or Treatment

Full Body Scan Without Breast
Full Body Thermogram Information Form

Upper Body Scan With Breast
Upper Body Thermogram Form
Breast Thermogram Form
Form for Patients with a History of Breast Disease or Treatment

Upper Body Scan Without Breast
Upper Body Thermogram Form

Lower Body Scan
Lower Body Thermogram Form

Region of Interest / Special Study
Region of Interest/Special Study Thermogram Form