Welcome to DeFabio Chiropractic Spine & Sports Rehab!
You are welcome to fill out your paperwork prior to your arrival. We are happy to answer your questions!
Online Forms
Online patient forms, completed in the convenience of your home or office!
- Download the necessary form(s), print it out, and fill in the required information.
- Fax, scan, or bring us your printed and completed form(s) to your appointment.
Chiropractic New Patient Health History Forms (overall health history):
New Patient Forms| Back Index| Lower Extremity Index| Neck Index| Upper Extremity IndexPsoriasis New Patient Health History Forms
New Patient Forms| CAAB-25 Questionnaire| Histamine Intolerance Questionnaire| Diet Diary
Auto Accident Form (additional information as applicable)
Medicare Patients (additional information as applicable)
Additional Medicare Forms| Back Index| Neck Index
Download the Free AdobeReader®
DeFabio Chiropractic Spine & Sports Rehab Financial Policies & Fees
DeFabio Chiropractic Spine & Sports Rehab offers a variety of payment options. We accept insurance as well as extend direct pay options of cash, check, and credit cards. Our staff is happy to verify and explain your benefits before you start a chiropractic care plan.
It is your obligation to understand your insurance coverage and insurance company's policies. Any services not covered by insurance are your responsibility.
| Service | Fees |
| Standard Office Visit/Adjustment | $90-$125 |
| Initial Comprehensive Examination | $160-$385 |
| Interim Re-Examination | $135-$160 |
| Psoriasis/Nutritional Consultation |
$195 |
| X-rays | $95-$240 (per region) |
| Therapeutic Activities (exercise, Graston, ART, stretching) | $110 |
| Decompression | $75 |
| Cold Laser | $50 |
| Muscle Stimulation | $50 |
| Orthotics, Supports, Appliances, Supplements | Per Item |
| Kinesio-Tape | $15 per area |
| Small group personal training | $250 for 6 sessions |
| Radial Pulse Wave (RPW) | $50-$500 |
| Winback (TECAR) | $25--$150 |
| Care Wear Patch | $70/ patch: $50/wk rental |
| Ultrasound | $42 |
| Trim & Tone | $150/session |
| PEMF & Infrared Mat | $20 |
| Vibration Plate | $20 |