AO Scan Profile Setup

Please fill out the information below to set up your profile for the AO Scan.
You only need to do this once. After that, you are in the system.
If you have already received a scan from our device, you may skip this setup page.

This is NOT requesting services...only setting you up in the system.

This information never leaves my personal device, it will only be used to set up a profile

on the AO Scan Technology program to perform the scans.

Name of Person that Will be Scanned

First Name *

Last Name *

Email *

Gender *

Male

Female

Weight in Pounds *

Height in Inches *

Date of birth *

Is this profile being set up for the 21- Day InnerVoice Challenge? *

Yes

If yes, and you would like to receive text reminders during the challenge, please list your number below.

Please upload a current photo with no glasses, jewelry, or hat. Use a solid, light-colored background, if possible.

This is not required for the scan, but helps me to identify who I am scanning.

Photo of Yourself *