*Fill-out these forms after you have a confirmed appointment and if it's your first time with BnBLV. 
 

THERMOGRAPHY

Note: Please Print all 4 FORMS. 

BnBThermography Patient Preparation Instructions

Welcome to our Center. Before you arrive for your thermogram, certain protocols must be followed in order to ensure that your images reflect accurate information. Pls. read/print the following instructions and strictly adhere to them. Thanks

1. Open PDF File & Print

BnBThermography Breast Intake Form

Pls. open/print the file and accomplish form...

2. Open PDF File & Print

BnBThermography Full Body Intake Form

Pls. open/print file and accomplish form...

3. Open PDF File & Print

BnBThermography IRT Consent Form

Please open/print file and accomplish form...

4. Open PDF File & Print
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Set Appt. Here

Open Every:

Monday - Friday: 8:00am - 5:00pm

Saturday: 8:00am - 3.00pm 

7656 W. Sahara Ave. #120 Las Vegas, NV 89117

Body In Balance LV Accepts Only : CASH &

DISCLAIMER

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Body In Balance of Las Vegas massage sessions and other therapies are for general wellness purposes. For serious conditions, clients should see a doctor or other appropriate healthcare provider for diagnosis and treatment of any suspected medical problem. Also, it is your responsibility to keep your massage/therapy practitioner informed of any changes in your health and any medications that you may begin to take in the future.

State License 0337

City License M12-00795

City Establishment License M03-97620

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© 2020 Body In Balance Las Vegas. by @Simple IT Today

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