Online Forms

Delaino Chiropractic Clinic offers our patient form(s) online so they can be completed 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 Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Download the Free Adobe Reader®

Insurance Information:

We verify medicare insurance plans, but most of our services are OOP. Although each patients rates are different because our care is very individualized, it is very reasonably priced and much like paying a copay for insurance. 

Medicare does cover chiropractic to a certain point, we can file claims for you from our office!

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