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 to Studies
Notice of Privacy Practices

Breast Scan Only
Breast Health Questionnaire
For Patients with a History of Breast Disease or Treatment

Full Body Scan With Breast
Full Body Questionnaire
Breast Health Questionnaire
For Patients with a History of Breast Disease or Treatment

Full Body Scan Without Breast
Full Body Questionnaire

Upper Body Scan With Breast
Upper Body Questionnaire
Breast Health Questionnaire
For Patients with a History of Breast Disease or Treatment

Upper Body Scan Without Breast
Upper Body Questionnaire

Lower Body Scan
Lower Body Questionnaire

Region of Interest / Special Study
Region of Interest / Special Study Questionnaire