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.
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