La Barbera Family Chiropractic, LLC

"Where Precision Matters"

Complete Chiropractic Spinal, Extremity and Cranial Care

Celebrating 36 years -- 1986 to 2022

      2719 Genesee Street       Utica, NY   13501      

  Phone  315-724-0368       Fax   315-724-0374


Home Dr. La Barbera Services Technology Education Office Photos Sick or Healthy? Brain Stem Children Results Safe & Natural Foot Orthotics New Patient Forms Out Of Town Links Newsletter Articles Privacy Feedback Search Disclaimer FAQ's / Billing Videos Supplements  









Thank you for showing an interest in becoming a practice member of our office and bringing your family's health to the next level.  The commitment of being a chiropractic patient starts with a complete case history form for one of our doctors to review.  While chiropractic is not about treating diseases, pain or conditions, we do need to know all about your past health history and any concerns you may have at the present time.  This information will direct the doctor in the proper care of you and your family so that we may obtain the best results in the shortest period of time.  If you need to add additional information, feel free to include a separate sheet with these three forms.  When scheduling a visit for a child (newborn to age 17), include information about the mothers’ prenatal care, pregnancy information (medications, ultrasounds, injuries, vaccines received, vitamins, health habits) as well as the birth process, complications, APGAR score and so forth.  Please mail or drop off these forms before your visit so they can be reviewed.  Also, if you  have had  any recent (within the past 6 months) X-Rays, MRI Scans or CAT Scans of your spine, it is of great importance that these are brought to our office with the reports at least three days before your scheduled examination.  All of this detail is absolutely necessary for us to be able to assist you to the best of our ability.  Thanks again for considering us and we look forward to meeting you and your family!  

Download and print the forms in Adobe format.  If you do not have the Adobe Reader, you may download it for FREE at .   If you prefer, you may call our office (315-724-0368) and we will be happy to mail them to you or stop by to pick them up in person.


Click  HERE  to download the new patient paperwork.  Please be as complete as possible and write neatly. Thank you for your cooperation.  If you have more than 4 problems / main complaints / symptoms, please click HERE for an additional sheet.  If you have any questions, please do not hesitate to contact us.  We look forward to caring for you and your family.



Send mail to with questions or comments about this web site.
Copyright © 2003 LaBarbera Family Chiropractic, LLC
Last modified: 03/02/15