DeFabio Chiropractic Spine & Sports Rehab offers our patient forms online so they can be completed in the convenience of your own home or office, before you arrive.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax, scan, or bring us your printed and completed form(s) to your appointment.
Chiropractic New Patient Health History Forms
These forms give Dr. DeFabio an overall history of your health.
New Patient Forms
Lower Extremity Index
Upper Extremity Index
Psoriasis New Patient Health History Forms
These forms give Dr. DeFabio an overall history of your health. Please fill out ALL forms listed below
Histamine Intolerance Questionnaire
Auto Accident Form
If your health issue is the result of a car accident, we need some additional information.
If you are a Medicare patient, this information is necessary for processing your claims.
ADDITIONAL Medicare New Patient Form