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Mammography Patient Questionnaire (Female)
Mammography Patient Questionnaire (Male)
Dexascan Patient Questionnaire
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Jeffrey A. Goldstein, MD, F.A.C.G.
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What is a Certified Nurse Midwife?
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Golf Fit
Senior Fitness Training
Hand Therapy
Lymphedema Therapy
Pelvic-Women's Health Therapy
SafeGait 360 Balance and Mobility Trainer
Speech Therapy
SPEAK OUT!®
TMD Rehabilitation
Vertigo Treatment
Rehab Staff
Physical Therapists
Occupational Therapists
Athletic Trainers
Speech Therapists
Acute Care Staff
Continuing Care Center Staff
Farmington Staff
Rehab Administration
Victor Rehabilitation Staff
Surgical Services
General Surgery
Theodor I. Kaufman, MD
A. David Peter, MD
Andrew Powers, MD
Joseph Talarico, MD
Jennifer Topor, NP
Christine Lyon, NP
Bradley J. Hensley, MD
Breast Cancer Surgery
Corneal Transplants
Hernia Surgery
Vascular Surgery
Endovascular Aneurysm Repair
For Patients
Ambulatory Procedures Center
Anesthesia
Pre-Admissions Testing Center
Day of Surgery
After Surgery
Intensive Care
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Occupational Medicine | HealthWorks
HealthWorks Forms
Industrial Rehab Services
Occupational Health Services
Workplace Safety
Pharmacy
Sands Cancer Center
Urgent Care
Wound Care
Patients & Visitors
Patient Guide
Coming to the Hospital
Smoking
What to Bring
While You're Here
Cards & Flowers
Caring for You
Meals & Snacks
Visitors
Your Room
Going Home
Organ Donation
LGBTQ Patients
Patient Rights
Policy of Non-Discrimination
Rights & Responsibilities
Your Bill
National Healthcare Decisions Day
Comfort & Convenience
Gift Shop & Flowers
Smoke Free
Support Groups
Visitor Information
Billing & Insurance
Cost Estimates & Pricing
Financial Aid
Your Insurance & NY State Out of Network Law
Health Information Management
FAQs
Social Work
Star Catcher
Caring Bridge
General Info & Hours
Parking
Spiritual Care
Discharge with Dignity
Education
Calendar of Events & Classes
Event Details
Stroke
Athletic Training Corner
Support Groups
Birthing Classes
Partners In Health and Wellness
Ovarian Cancer
Wellness Briefs
Senior Living
M.M. Ewing Continuing Care Center
Post Hospital Services
Dementia Care
Long Term Services
M.M. Ewing Admissions
Clark Meadows
Short Stay
Map & Directions
Ferris Hills at West Lake
Resources
Foundation
Board of Directors
Mary Clark Thompson Grants
MCT Grant Recipients
Planned Giving
Thompson Guild
Guild Holiday Pie Sale
Tree of Lights
Guild Gallery Gift Shops
Guild History
Join the Guild
Guild's Scholarship
Guild Fashion Show
Donating
Publications
Special Events
Thompson Health Golf Classic
Thompson Health Gala
Thompson Health Western Roundup Gala
Gala Sponsorship Thank You
Event Photo Gallery
Volunteering
Honor Your Doctor
Planning a Fund Raiser
Family
Opt-out
Careers
Careers
Nutrition Services
Nursing
Nursing at Thompson Health
Nursing at F.F. Thompson Hospital
Magnet Designation
Nursing Leadership
Nursing Philosophy & Vision
Nursing Practice Council
Clinical & Professional Development
Nursing Career Opportunities
Nursing - Senior Living
Nursing Career Opportunities
CNA Apprentice Program
Daisy
Daisy Nomination
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Physician
Family Medicine Physician Opportunity
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Diagnostic Imaging Forms
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Diagnostic Imaging
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Diagnostic Imaging Forms
Birthing Center
Birthing Center Classes
Breastfeeding Support
Cardio and Pulmonary Service
Cardiac Rehabilitation
Diagnostic Imaging
Computed Tomography (CT)
Interventional Radiology
Interventional Radiology Team
Uterine Fibroid Embolization
Varicose Vein Ablation
DVT & PE Treatment
Mammography
Nuclear Medicine
X-ray
Ultrasound
MRI
Breast MRI
Diagnostic Imaging Forms
Bone Density
Breast Imaging Center
Our Services
Mammography
Breast Ultrasound
Breast Biopsies
Breast MRI
Bone Density Screening
Savi Scout Radar Localization
Breast Health Information & Recommendations
Forms
BIC Authorization Form
Mammography Patient Questionnaire (Female)
Mammography Patient Questionnaire (Male)
Dexascan Patient Questionnaire
Breast Health / Cancer Patient Navigation
Dialysis / Nephrology Services
Emergency Medicine
Urgent Care
Find A Provider
Physician Guides
Gastroenterology
Jeffrey A. Goldstein, MD, F.A.C.G.
Laboratory Medicine
Medical Nutrition Therapy
Bariatric Surgery Program
Observation Unit
Obstetrics and Gynecology
OB-GYN Ultrasound
Cancer Genetic Testing
Gynecologic Surgery
What is a Certified Nurse Midwife?
Occupational Medicine | HealthWorks
HealthWorks Forms
Industrial Rehab Services
Occupational Health Services
Workplace Safety
Orthopaedic Surgery
Orthopaedic Surgeons
Orthopaedic Care Team
Pain Management
Pediatrics
Kids
Pharmacy
Primary Care
Be Proactive
Primary Care Practices FAQ
Physician Assistant
Nurse Practitioners
Doctors of Osteopathic Medicine - DO
Billing & Insurance Info
Patient-Centered Medical Homes
Canandaigua Family Practice
Canandaigua Medical Group Internal Medicine
Farmington Medical Group Family Medicine
Finger Lakes Family Care
Honeoye Family Practice
Lima Family Practice
Macedon Family Practice
The Mary Clark Thompson Family Practice
Midlakes Family Practice
Pediatrics
Shortsville Family Practice
Victor Family Practice
Family Practice Patient Portal
Primary Care Access Easy Form
Pulmonary Services
Pulmonary Clinic
Pulmonary Rehabilitation
Rehabilitation Services
Farmington Rehabilitation
Victor Rehabilitation
Victor Rehabilitation Staff
Physical Therapy
Occupational Therapy
Aquatic Therapy
Athletic Training
Athletic Training Corner
Active Release Technique
Core Strength & Conditioning
Golf Fit
Senior Fitness Training
Hand Therapy
Lymphedema Therapy
Pelvic-Women's Health Therapy
SafeGait 360 Balance and Mobility Trainer
Speech Therapy
SPEAK OUT!®
TMD Rehabilitation
Vertigo Treatment
Rehab Staff
Physical Therapists
Occupational Therapists
Athletic Trainers
Speech Therapists
Acute Care Staff
Continuing Care Center Staff
Farmington Staff
Rehab Administration
Victor Rehabilitation Staff
Sands Cancer Center
Sleep Disorders
Common Sleep Disorders
Sleep: Did You Know...?
Stroke Center at F.F. Thompson Hospital
Learn About Stroke
Stroke Support Group
Surgical Services
General Surgery
Theodor I. Kaufman, MD
A. David Peter, MD
Andrew Powers, MD
Joseph Talarico, MD
Jennifer Topor, NP
Christine Lyon, NP
Bradley J. Hensley, MD
Breast Cancer Surgery
Corneal Transplants
Hernia Surgery
Vascular Surgery
Endovascular Aneurysm Repair
For Patients
Ambulatory Procedures Center
Anesthesia
Pre-Admissions Testing Center
Day of Surgery
After Surgery
Urgent Care
Women's Health
Telehealth
Intensive Care
Wound Care
Diagnostic Imaging Forms
Below are forms that you may need for your appointment. Please download the form, fill it in and bring it with you to your scheduled appointment. All forms are PDF's and are editable if you have an updated version of Acrobat, otherwise you may print it and fill it in for yourself or your loved one.
Mammography Female Patient History Form
Mammography Male Patient History Form
Bone Density History Form
Release Of Information Form