Prior to your visit, click the appropriate links to download forms. Fill them out at home, and bring them with you for your appointment.

First Time Breast Imaging

• Pre-Breast Imaging Instructions form
• Thermal Image Authorization and Release form
• Breast Health History form
• Breast Cancer Risk Assessment form

Routine Breast Imaging

• Pre-Breast Imaging Instructions form
• Thermal Image Authorization and Release form
• Breast Health Follow up form
• Breast Cancer Risk Assessment form

Cranial/Dental/Thyroid Imaging

• Pre-Breast Imaging Instructions form
• Thermal Image Authorization and Release form
• Cranial Dental Health History Intake

Upper or Lower Body Imaging

• Pre-Breast Imaging Instructions form
• Thermal Image Authorization and Release form
• Full Body Form & Pain History form Part I
• Full Body Form and Pain History form Part II

Full Body Imaging

• Pre-Breast Imaging Instructions form
• Thermal Image Authorization and Release form
• Breast Health History form
• Cranial Dental Health History Intake
• Breast Cancer Risk Assessment form
• Full Body Form & Pain History form Part I
• Full Body Form and Pain History form Part II

If you have any problems or issues with accessing any of these forms,
please call the clinic directly at  780.455.6123 or contact us via email.