Accessibility View Close toolbar

Call Us Today

201-746-0640

Open mobile navigation

Online Forms

Miano Family Chiropractic Center, LLC offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • 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 us your printed and completed form(s) or bring it with you to your appointment.

New Patient Registration Form - Required

Please take your time and fill out this form as completely as possible.  This supplies our office with the personal and insurance information necessary to become a new patient.

Download & Print Form

New Patient Health History Form - Required

Please be sure to fill out all pages of the form(s) completely.  This allows us to gather the information needed to properly analyze your condition and recommend appropriate care.

Chiropractic Intake Form (Adult): Download & Print Form

Chiropractic Intake Form (Pregnancy): Download & Print Form

Chiropractic Intake Form (Pediatric): Download & Print Form

Acupuncture Intake Form: Download & Print Form


Download the Free AdobeReader®

Welcome New Patients!

Featured Services

Office Hours

Our Regular Schedule

Miano Family Chiropractic Center, LLC

Monday:

10:00am - 12:45pm

3:00pm - 6:30pm

Tuesday:

Closed

Wednesday:

By Appointment

3:00pm - 6:30pm

Thursday:

Closed

Friday:

10:00am - 12:45pm

3:00pm - 6:30pm

Saturday:

10:00am - 12:00pm*

Sunday:

Closed

Location

Find us on the map

Testimonials

  • "We value our patients' experience at the Miano Family Chiropractic Center, LLC. If you are currently a patient, please feel free to complete the following Chiropractic and/or Acupuncture Questionnaire. Please bring in your completed form to let us know what you think!"
    Jennifer L. Miano, DC, CACCP

Featured Articles

Read about interesting topics

  • Left-Handers Day

    Left-Handers Day Left-Handers Day, celebrated on August 15th, was launched in 1992 by the Left-Handers Club, an organization based in the United Kingdom. Since then, Left-Handers Day has become a worldwide event and social media phenomenon. Around the world, approximately one in ten persons is left-handed. ...

    Read More

  • Peak Experiences

    Peak Experiences The American philosopher and naturalist Henry David Thoreau roamed far and wide over the hills and mountains of his native Massachusetts and neighboring New Hampshire. In his masterwork, "Walden," Thoreau famously stated that we must "reawaken and keep ourselves awake, not by mechanical ...

    Read More

  • Dynamic Warm-ups

    In a common occurrence, you bend over to pick up the pencil you inadvertently dropped on the floor. Or you bend over to pick up the soap bar that has slipped through your fingers in the shower. Or you bend over to lift a bag of groceries out of your automobile trunk. These are all daily events. But on ...

    Read More

  • Summer Sports

    Summer Sports In the summertime, everyone's thoughts turn to the outdoors. We want to get out in the sun and have some fun. Some people do exercise outdoors, such as running, walking, and biking, all year long regardless of the weather.1 For others, summer's warmer temperatures make activity outside ...

    Read More

  • Wellness Gardens

    Wellness Gardens When time is spent in an office or indoors day in and day out, some can lose that connection to the outside world. And that loss of connection can lead to higher stress levels and more health ailments without even realizing it. But when that the gap between office life and outdoor life ...

    Read More

  • Smart Shoulders

    Our shoulder joints have the greatest range of motion of any of the musculoskeletal joints in our bodies. The shoulder joint is really two joints, the glenohumeral joint between the arm bone (humerus) and the shoulder blade (scapula) and the acromioclavicular joint between the acromion (a bony projection off the scapula) and the collarbone (clavicle). The glenohumeral joint is a ball-and-socket joint and the acromioclavicular joint is a gliding joint. ...

    Read More

  • A Book and Its Cover

    A book cover may not necessarily tell the whole story and may not accurately portray the nature of the contents within. Publishing companies pay high salaries to their marketing staff to create cover copy that will entice prospective buyers to make a purchase. But many times the book itself does not ...

    Read More

  • When Your Spine Is In Line

    Good spinal alignment means good biomechanical health. Essentially, your spine is the biomechanical center of your body. Your legs are connected to your spine via two large and strong pelvic bones. Your arms are connected to your spine via your shoulder blades, ribs, and numerous strong muscles and ligaments. ...

    Read More

  • An Apple a Day . . .

    What is so good about an apple? Is it the color, ranging from ruby red to pale pink? Is it the crunch? The sweetness? Or is it, instead, a combination of all of these qualities, plus the natural goodness derived from the apple's secret ingredients — phytonutrients? If this were a multiple choice quiz, the answer would be "all of the above". Importantly, in addition to possessing numerous appealing physical qualities, apples contain an abundance of health-promoting biochemicals known as phytonutrients.1,2 These specific organic molecules are derived not only from apples but many other fresh fruits and vegetables, and help power the immune system, protect against cancer, maintain healthy eyes, and assist cells in clearing out metabolic waste products such as free radicals. ...

    Read More

  • Standing Tall

    Young peoples' bones stop growing by approximately age 20, somewhat earlier in women and somewhat later in men. Long bone growth, that is, in the arm, forearm, thigh, and leg, ceases later and smaller bone growth, that is, in the hands, feet, and spine, ceases earlier. In essence, you're as tall as you're ...

    Read More

Newsletter Sign Up