Online Forms

We offer our patient forms online so they can be completed prior to your first visit.


New Patient Registration - Completion Required

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

Download & Complete


Health History Form - Completion Required

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

Chiropractic Intake Form (Adult): Download & Complete

Chiropractic Intake Form (Prenatal): Download & Complete

Chiropractic Intake Form (Pediatric): Download & Complete


HIPAA Notification - Review Required

Please download and review this form. This is your notification of the HIPAA practices we utilize to protect your personal and medical information. You can print this out for your records, we do not require you to turn in a copy at the office. 

Download & Review


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Location

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Office Hours

Our Regular Schedule

Miano Family Chiropractic Center, LLC

Monday:

Closed

Tuesday:

3:00 pm-7:00 pm

Wednesday:

Closed

Thursday:

10:00 am-1:00 pm

Friday:

3:00 pm-7:00 pm

Saturday:

Closed

Sunday:

Closed

Welcome New Patients!