Thermography Patient Forms and Pre-scan Instructions
New Thermography Patient Forms
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You can choose to click on your intake forms below to download & complete prior to your appointment.
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Women's Half Body Scan (Health Screening)
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Men's Half Body Scan (Health Screening)

Appointment Preparation / Pre-Scan Instructions
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YOU MUST WAIT AT LEAST THREE (3) MONTHS AFTER MAJOR BREAST SURGERY, COMPLETION OF
CHEMOTHERAPY, OR RADIATION BEFORE A THERMAL EXAM
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YOU MUST WAIT AT LEAST ONE (1) MONTH AFTER A BIOPSY OR MINOR SURGERY AVOID TANNING
OR SUNBURN AT LEAST ONE WEEK PRIOR TO APPOINTMENT
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DO NOT EAT 1 HOUR PRIOR TO YOUR EXAM
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DO NOT EAT OR DRINK CAFFEINATED PRODUCTS 2 HOURS PRIOR TO YOUR EXAM
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DO NOT SMOKE OR USE ANY PRODUCTS CONTAINING NICOTINE 2 HOURS PRIOR TO YOUR EXAM
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DO NOT EXERCISE OR SUNBATH 12 HOURS PRIOR TO YOUR EXAM
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DO NOT USE LOTIONS, POWDERS, OR DEODORANTS ON THE DAY OF YOUR EXAM
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AVOID TAKING ANY MEDICATIONS OR SUPPLEMENTS ON THE DAY OF YOUR EXAM**
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PLEASE WEAR LOOSE FITTED CLOTHING
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IF HAVING A HALF OR FULL BODY SCAN, HAIR WILL NEED TO BE PULLED BACK OFF OF THE FACE & NECK (WE HAVE DISPOSABLE HAIR SUPPLIES FOR YOUR CONVENIENCE)
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IF YOU HAVE THICK CHEST OR BACK HAIR, PLEASE SHAVE DOWN AS CLOSE TO THE SKIN AS YOU CAN. THERMAL IMAGING CANNOT SEE THROUGH THICK HAIR.
Please inform your Thermography Technician about any recent skin lesions or bruising, Rosacea or any other skin
disorders as it may cause false positives on reports.
**Necessary medications-such as blood pressure or heart medications are permitted-please notify the technician
For your convenience, you can print your ​patient forms​ to fill out and bring with you on your appointment.
PROCEDURE:
To receive accurate results, the acclimating time (the time it takes for your body to adjust to the room temperature)
is approximately 15 minutes and the room temperature will be between 68-72 degrees.
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A gown will be provided for you to wear during this time so you will not be completely unclothed. Once the scanning procedure begins, you will be asked to move the gown to certain positions to capture certain images keeping you as comfortable as possible at all times.
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