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 814-883-0006

These Forms are Required for Upper Body Scans

Pt. prep sheet – Full Body

Patient Intake Form

Review of Systems

Upper Body Questionnaire

Breast Questionnaire

HIPAA

Extended Breast Questionnaire – only if you had breast cancer or breast surgery

Request For Alternative Cummunications

"Essence of Pure Living, LLC., Wholistic Thermography, and Equine Thermography exist to help you learn, research and make good choices for your wellness. We are not attempting to diagnose, prescribe, treat any medical condition you have. Information included on this site is not intended to diagnose, prescribe, prevent, treat or cure any issue, illness, disease or condition you have. "


Home Office:
Essence of Pure Living
164 Luna lane
Johnstown, pa, 15904

Remote Offices:
Toftrees Family Medicine
811 Cricklewood Ave.
State College, PA, 16803

Bieber Family Chiropractic
292 Main St.
Turbotville, PA 17772

Live Well Chiropractic
1634 Quaker Valley Rd.
New Paris, Pa 15554

Health by Choice
1721 Lafayette Road
New Enterprise, PA 16664

Coming Soon
Lewistown, PA
Address

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