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FORMS & INFORMATION

NEW CLIENTS: PLEASE FILL THESE FORMS OUT & BRING THEM WITH YOU TO YOUR APPOINTMENT.

 

FOR FOLLOW-UP BREAST SCANS OR ANNUAL RETURN APPOINTMENTS, WE WILL SIMPLY UPDATE ANY CHANGES AND ADD THEM TO YOUR HEALTH HISTORY ON FILE AT THE APPOINTMENT SO NO NEED TO PRINT.

CHECKLIST - TO ENSURE THE BEST IMAGING, PLEASE READ AND FOLLOW THESE INSTRUCTIONS:

HEALTH HISTORY INTAKE – PLEASE REVIEW AND COMPLETE ALL SECTIONS FOR BEST RESULTS

CONSENT FORM – PLEASE REVIEW AND COMPLETE BEFORE SIGNING TO CONFIRM YOUR UNDERSTANDING AND CONSENT.

HEALTH HISTORY INTAKE – PLEASE REVIEW AND COMPLETE ALL SECTIONS FOR BEST RESULTS

SEND US A MESSAGE

Have any questions? Reach out to us and we will get back to you as soon as we are able!

CONTACT US

EMAIL
lighthouse4health@gmail.com

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PHONE

Sue (763) 227-5347

Barb (763) 227-2807

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LOCATIONS

PRIMARY LOCATION:

Albertville, MN

5676 La Centre Ave NE, Suite 204

Albertville, MN 55301

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Directly across the parking lot from Coborn's grocery store.

ROTATING LOCATIONS:

Alexandria, MN

Andover, MN

Bloomington, MN

Burnsville, MN

Champlin, MN

Eden Prairie, MN

Jordon, MN

Little Canada, MN

Minnetonka, MN

Park Rapids, MN

Rice Lake, WI

Sauk Rapids, MN

Savage, MN

Stillwater, MN

© Copyright 2026 Lighthouse Health & Thermography

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