Online Patient Intake Form
Please read the Mandatory Protocols for Thermal Imaging
Mandatory Protocols for Thermal Imaging
Patient Preparation:
Thermal imaging is a heat sensitive test. Anything which creates heat should be avoided prior to testing. Excessive metabolic activity, friction, or any of the activities listed below which will alter heat readings.
1 Month Prior:
- No minor breast surgery, i.e. biopsy
- We may still perform testing after biopsy. Write this in form.
1 Week Prior:
- Be cautious of too much sun exposure in order to avoid sunburn. Scans will have to be rescheduled if the patient has a sunburn of any sort.
48 Hours Prior:
- Men with beards should shave their face and neck, as well as backs
- Avoid all tanning and limit sun exposure
24 Hours Prior:
- Avoid chiropractic care, massage therapy or acupuncture
- No saunas, steam baths, hot tubs, heating pads, or hot water bottles
- No analgesic creams or balms
- Do not shave underarms (Should be done prior)
- Reschedule if you experience a significant fever
- Refrain from sexual activity
Day of Exam:
- For best results, please wear thong underwear or a jock strap for full body studies. Underwear is optional and best results are without.
- Do not use creams, lotions, cosmetics, ointments, deodorant, antiperspirants, powders or any other skin product
- Please bring a hair tie to remove hair from your forehead and back of neck
- Remove all piercings and jewelry prior to exam, unless unable to.
4 Hours Prior:
- Avoid hot showers or shaving
- Avoid physical therapy or exercise
- No coffee, tea, soda, or other beverages containing caffeine. No alcoholic beverages.
- Do not smoke cigarettes or use any product which contains nicotine
Women- do not wear a bra for the 4 hours leading up to the exam 2 Hours Before the Exam:
- Avoid hot or cold liquids
- Avoid eating or chewing gum
- Avoid using a cell phone
Prior to and During Exam:
- Please inform us if you have a hot flash during the session
- Try to relax prior to and during the exam. Stress will affect your exam.