Thermography Center of Memphis
  • Home
    • Learn More
  • Services
    • Breast Health
    • Body Health
  • FAQ
  • Blog
  • Schedule Appointment
  • Procedure Forms
  • Videos
  • About Us
    • Testimonials
    • In The News
    • Out 'n' About
  • Contact

Procedure Forms

All of the forms that you need to fill out and bring with you for your appointment are included in the folders below. Please choose the folder according to the area you are having screened. Choose the region of interest forms (ROI) if your screening will be on areas other than breast or full body. 

For ROI, complete either the upper or lower body form from the packet along with all the other forms. Included in all packets will be a preparation sheet. It is very important to follow these guidelines. Please call us if you have any questions.

 
Breast Forms
File Size: 813 kb
File Type: zip
Download File

Region of Interest Forms
File Size: 876 kb
File Type: zip
Download File

Full Body Forms
File Size: 909 kb
File Type: zip
Download File

Client Intake Form
Sample Client Intake Form
DISCLAIMER: Thermography Center of Memphis LLC is not a treatment or diagnosing center and is not engaged in rendering health care advice. The information provided through this website should not be used for diagnosing or treating a health problem or disease. The authors, editors, and contributors shall have no liability, obligation or responsibility to any person or entity for any loss, damage, or adverse consequence alleged to have happened directly or indirectly as a consequence of this material. All digital scans are analyzed/interpreted by its interpretive service provider. Please consult a qualified healthcare practitioner when seeking medical advice.
© Copyright 2012-2026 by Thermography Center of Memphis. All rights reserved.