Please call our office at 540-368-5558 to schedule your appointment. We can send you the forms or you can download them from this site (see below); please fill them out prior to your appointment and bring with you. Please arrive 15 minutes before your scheduled time.

FORMS DOWNLOAD:
If you need Adobe Acrobat Reader, click here to download it.

FOR BREAST THERMOGRAPHY PATIENTS:

• Patient Registration PDF file or MSWord file

• Consent Form PDF file or MSWord file

• Breast Health History PDF file or MSWord file

• Medicare Form (if applicable) PDF file or MSWord file

• Instruction Sheet PDF file or MSWord file

FOR TMJ/UPPER/LOWER THERMOGRAPHY PATIENTS:

• Patient Registration PDF file or MSWord file

• Consent Form PDF file or MSWord file

• Health History PDF file

• Medicare Form (if applicable) PDF file or MSWord file

• Instruction Sheet PDF file or MSWord file