| © 2 0 1 1 P R O A C T I V E H E A L T H S O L U T I O N S , L L C | A L L R I G H T S R E S E R V E D |
| © 2 0 1 1 P R O A C T I V E H E A L T H S O L U T I O N S , L L C | A L L R I G H T S R E S E R V E D |
Be Proactive and
Get Started
STEP#2: PREPARE THE NECESSARY FORMS
Note: Please print these forms once complete as they cannot be re-saved to your computer. Bring all forms to appointment:
Note: Please print these forms once complete as they cannot be re-saved to your computer. Bring all forms to appointment:
» NEW PATIENT INFORMATION SHEET (PDF)
» PATIENT AUTHORIZATION FORM (PDF)
» BREAST THERMOGRAPHY CONFIDENTIAL QUESTIONNAIRE (PDF)
» COMMUNICATION PRIVACY AUTHORIZATION FORM (PDF)
» PATIENT AUTHORIZATION FORM (PDF)
» BREAST THERMOGRAPHY CONFIDENTIAL QUESTIONNAIRE (PDF)
» COMMUNICATION PRIVACY AUTHORIZATION FORM (PDF)
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| California FOR SCHEDULING (ALL LOCATIONS): (714) 891-3390 FAX: (714) 893-5326 PO Box 6308 Garden Grove 92846-6308 (Click below for locations/maps) (7 Locations) |
| Proactive Health Solutions, LLC |
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| PROUD MEMBER OF THE AMERICAN MEDICAL THERMOLOGY SOCIETY, INC. |
STEP#3: FOLLOW TEST PREPARATION GUIDELINES
The effectiveness of your scan is directly influenced by adhering to the following:
The effectiveness of your scan is directly influenced by adhering to the following:
» NO CAFFIENE & NO NICOTINE 2 HOURS PRIOR TO YOUR APPOINTMENT
» NO LOTIONS, OILS, POWDER, PERFUME, MAKEUP OR DEODERANT TO THE REGION(S) BEING IMAGED
» NO MASSAGE, CHIROPRACTIC OR ACUPUNCTURE TREATMENTS TO THE REGION(S) BEING IMAGED
» NO INFRARED SAUNA, EXCESSIVE SUN EXPOSURE OR HOT TUB USE
» NO HEAVY EXERCISE ON THE MORNING OF YOUR SCAN/EXAM
» ANY SURGICAL PROCEDURE TO THE BREAST REGION WILL REQUIRE A (3) MONTH PERIOD OF HEALING
BEFORE UTILIZING THERMAL IMAGING TECHNOLOGY
» NO LOTIONS, OILS, POWDER, PERFUME, MAKEUP OR DEODERANT TO THE REGION(S) BEING IMAGED
» NO MASSAGE, CHIROPRACTIC OR ACUPUNCTURE TREATMENTS TO THE REGION(S) BEING IMAGED
» NO INFRARED SAUNA, EXCESSIVE SUN EXPOSURE OR HOT TUB USE
» NO HEAVY EXERCISE ON THE MORNING OF YOUR SCAN/EXAM
» ANY SURGICAL PROCEDURE TO THE BREAST REGION WILL REQUIRE A (3) MONTH PERIOD OF HEALING
BEFORE UTILIZING THERMAL IMAGING TECHNOLOGY
STEP#1: SCHEDULE YOUR APPOINTMENT
New and existing patients please follow the appropriate link for scheduling:
New and existing patients please follow the appropriate link for scheduling:
» FOR NEW PATIENT PRELIMINARY SCHEDULING - CLICK HERE (Contact Us email form)
» EXISTING PATIENT WEB SCHEDULING/ARIZONA - CLICK HERE (Requires account creation/login)
» EXISTING PATIENT WEB SCHEDULING/CALIFORNIA - CLICK HERE (Requires account creation/login)
» EXISTING PATIENT WEB SCHEDULING/ARIZONA - CLICK HERE (Requires account creation/login)
» EXISTING PATIENT WEB SCHEDULING/CALIFORNIA - CLICK HERE (Requires account creation/login)
BREAST SCREENING PREPARATION
This quick and easy test starts with your medical
history being taken before you partially disrobe for
the scanning to be performed. This first session
provides the baseline of your "thermal signature"
by scanning several different views. A subsequent
session assures that the patterns remain
unchanged. All of your thermograms (breast
images) will be kept on record and once your
stable thermal pattern has been established, any
changes can be detected during your routine
follow-up annual studies.
Please follow ALL of the required steps
below in order for your Proactive Health
Solutions Certified Thermographer to
expedite and perform your scanning
session most efficiently.
This quick and easy test starts with your medical
history being taken before you partially disrobe for
the scanning to be performed. This first session
provides the baseline of your "thermal signature"
by scanning several different views. A subsequent
session assures that the patterns remain
unchanged. All of your thermograms (breast
images) will be kept on record and once your
stable thermal pattern has been established, any
changes can be detected during your routine
follow-up annual studies.
Please follow ALL of the required steps
below in order for your Proactive Health
Solutions Certified Thermographer to
expedite and perform your scanning
session most efficiently.
| Arizona FOR SCHEDULING (520) 235-7036 FAX: (520) 798-2468 3861 N First Avenue Tucson, AZ 85719 (1 block south of Roger Rd.) (Click below for location/map) (1 Location) |