La Barbera Family Chiropractic, LLC
"Where Precision Matters"
2719 Genesee Street Utica, NY 13501
Phone 315-724-0368 Fax 315-724-0374
NEW PATIENT FORMS
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
(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!
and print the forms in Adobe format. If
you do not have the Adobe Reader, you may download it for FREE at http://www.adobe.com/products/acrobat/readstep2_allversions.html
. 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 DrLaBarbera@LaBarberaChiro.com with
questions or comments about this web site.