Thermography Preparation

Review the preparation guidelines 

Female instructions: click here

Male instructions: click here

There are some things you must avoid in order to have an accurate reading. Feel free to call us at 281-803-5880 if you need to discuss specifics.

Fill out your health history forms

Look below for the type of appointment you are scheduled for and click on the button for the appropriate form to appear. These forms are to be filled in online. If you prefer to print your forms and bring them with you to your appointment, please click below.

Appointment Forms
 
Every appointment for thermography imaging requires corresponding forms, including clients that are returning for annual or baseline screenings. Our office staff is ready to assist if you are unsure of which forms correspond to the imaging service you selected, simply give us a call at 281-803-5880.
THE FORMS BELOW ARE FILLABLE PDF FORMS.  If you are unable to fill out the forms or would prefer to print them out and fill them out yourself, please click on the link below for printable forms.
 
 
 
Full Body Thermogram
Includes head, neck, chest/breast, back, abdomen, upper and lower extremities.
 
 
 
 
Upper Body Thermogram
Includes head, neck, chest/breast, back, abdomen, and upper extremities.
This is the second-best option to the Full Body, because it still includes the majority of the body.
Breast Thermogram
Multiple views of the breast area, including the upper chest and underarm regions are evaluated.
 
Region of Interest Thermogram
This option is for those who would like to evaluate one particular area (does not apply to breast region), such as the thyroid, lower back, or abdomen. Please contact our office to discuss your particular needs and we will determine which forms are appropriate for your appointment.
 

Need Assistance?  Call (281) 803-5880