pt froms page

Please download, print and complete the appropriate forms bring them with you for your first appointment. (No medical referral required.)

 

Every Patient Must Complete BOTH of the forms below prior to your appointment:

Pre-scan Instructions (required protocol to follow)

HIPPA Patient Authorization Form

 

Now Select Which Screening you are having and print/complete appropriate form:

 

Comprehensive Screenings:

Men’s Full Body Form

Women’s Full Body Form

Men’s Health Screening Form

Women’s Health Screening Form

 

Region of Interest Screenings:

Head, Neck, Thyroid Form

Breast Health Form

Cardiovascularhest

Abdomen Form

Extremities Only Form

Please call our office at 518-983-6564 with any questions as to which form to fill out.