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Client Forms

Painless, non-invasive, safe and radiation free

For your convenience, and to save you time we have made our client forms available to you online.
Please print the appropriate forms below, fill them out and bring them along with you to your scheduled appointment.

You will need Adobe Reader to be able to view and print the files. If you do not have Adobe Reader you can download it for free here

Which forms do I need to fill out?

 

If you are coming in for a: Please fill out these forms:
Breast Screening Breast Health
HIPPA Authorization form
Full Body Scan Full Body
HIPPA Authorization form
Upper Body Scan Upper Body
HIPPA Authorization form
Lower Body Scan Lower Body
HIPPA Authorization form
Specific Region of interest ROI (Specific Region of Interest)
HIPPA Authorization form
If you're not sure Full Body
HIPPA Authorization form

Please read below how to prepare for your appointment

What can I expect on my first visit?

How to prepare for your scheduled appointment

On the day of the appointment

Please follow these guidelines before your appointment

Please refrain from the following activities on the day or your appointment

  • physical therapy
  • massage
  • electromyography
  • chiropractic adjustments
  • Do not smoke for 2 hours before the test
  • Do not use lotions, deodorants, or liniments on day of test
  • Stay out of strong sunlight on the day of test (no tanning)
  • Try to wear loose clothing
  • Get your printable copy here

There are no dietary or medication restrictions on the day of your scan
IMPORTANT! .
If you develop a fever the day of or day before your visit please call our center to reschedule your visit

Upon arrival

When you arrive you will be given an intake questionnaire and the HIPPA (patient privacy) forms to fill out (If you have not already done so)
This is a good time to ask any questions about the procedure.

Before the scan

You will be led to a room were the imaging equipment is located and given a light weight gown to wear. You will be allowed to privately disrobe down to the underpants and put on your gown. You will be left in the room for about 5 to 10 minutes to allow for your body to acclimatize to the ambient temperature of the room before imaging begins.

During the 5 to 10 minute acclimatization period the technician will collect additional information from you relating to your symptoms and history. The focus will be on your primary complaints and concerns.

The technician should give you an explanation of how your body should be positioned for each photograph. please ask any questions that may be of concern.

Remember that this procedure is much like having your picture taken. There is no radiation, no contact with the body and that nothing will be felt.

The scan

The scan will involve a number of views being taken, each view only takes a couple of seconds, so the whole exam will be completed in a few minutes. You will be required to remain as still as possible for the couple of seconds it takes to capture the image.
It is not necessary for you to hold your breath.

We routinely take an anterior view followed by both lateral views and then a posterior view, sometimes oblique views are included.

The test is just like having your photograph taken, a thermographer focuses the scanner and takes an image which is saved onto the computer to be sent to a doctor for interpretation and reporting.

After the scan

The thermographer will submit the images for interpretation by the trained Medical Doctors who will then send back a comprehensive report of their findings within 72 hours (urgent reports can be completed within 24 hours)

Your report

Your report will contain useful information relating to your physiological status (or function of the body).

The interpretting doctor will identify any significant findings that relate to your symptoms and history and give an opinion that will help your treating doctor or healthcare practitioner.

Your doctor, dentist, chiropractor, therapist or other healthcare provider can contact the thermographer or reporting doctor with any questions.