To expedite your visit, we encourage you to complete the corresponding forms below.
Upon confirmation of your appointment , you will receive the necessary forms, appointment protocols and directions to the location your appointment will take place.
This information will help guide us to focus on your areas of concern as well as providing us with insights into the functioning of various organs, muscles, glands, nerves and more. The combination of information you provide and the information provided by the imaging offers a powerful look for assessing your health.
At the time of your appointment we will review the information to assure we understand and address the areas of concern. Choose the most applicable Questionnaire to complete along with the forms from one column below.
Upon confirmation of your appointment , you will receive the necessary forms, appointment protocols and directions to the location your appointment will take place.
This information will help guide us to focus on your areas of concern as well as providing us with insights into the functioning of various organs, muscles, glands, nerves and more. The combination of information you provide and the information provided by the imaging offers a powerful look for assessing your health.
At the time of your appointment we will review the information to assure we understand and address the areas of concern. Choose the most applicable Questionnaire to complete along with the forms from one column below.
Notice of Privacy
This form is required and must be completed by each patient prior to imaging.
Central Region Questionnaire
Includes: head, neck, breasts, chest, heart and lungs, abdomen and lower back and can show the following concerns: TMJ, sinus, dental, thyroid patterns, Muscular-Skeletal, early detection of cardiovascular disease, arthritis, Fybromyalgia or trauma such as strains, sprains or chronic pain, Chronic regional pain syndrome, nerve irritation that can cause referred pain in other areas and circulatory deficits.
Includes: head, neck, breasts, chest, heart and lungs, abdomen and lower back and can show the following concerns: TMJ, sinus, dental, thyroid patterns, Muscular-Skeletal, early detection of cardiovascular disease, arthritis, Fybromyalgia or trauma such as strains, sprains or chronic pain, Chronic regional pain syndrome, nerve irritation that can cause referred pain in other areas and circulatory deficits.
Full Body Questionnaire
Includes: head, neck, breasts, chest, heart and lungs, abdomen and lower back, legs, feet, arms and hands and can show: TMJ, sinus, dental, thyroid patterns, Muscular-Skeletal, early detection of cardiovascular disease, arthritis, Fybromyalgia or trauma such as strains, sprains or chronic pain, Chronic regional pain syndrome, nerve irritation that can cause referred pain in other areas and circulatory deficits.
Includes: head, neck, breasts, chest, heart and lungs, abdomen and lower back, legs, feet, arms and hands and can show: TMJ, sinus, dental, thyroid patterns, Muscular-Skeletal, early detection of cardiovascular disease, arthritis, Fybromyalgia or trauma such as strains, sprains or chronic pain, Chronic regional pain syndrome, nerve irritation that can cause referred pain in other areas and circulatory deficits.
Chest & Breast Questionnaire
Offering the opportunity to observe patterns related to the pectoral region of the chest, shoulder issues, posture, possible cardio signs, upper back issues, possible lung signs and an overall assessment of upper body inflammation and immunity.
Breast Questionnaire
It is important to know that both female and male have concerns of the breast. This form should be completed if a breast study is being requested.
It is important to know that both female and male have concerns of the breast. This form should be completed if a breast study is being requested.
