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308 Springfield Avenue

Berkeley Heights, NJ 07922

(908) 771-0220

Online Forms

DeFabio Chiropractic Spine & Sports Rehab offers our patient forms online so they can be completed in the convenience of your own home or office, before you arrive. 

  • 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, scan, or bring us your printed and completed form(s) to your appointment.

New Patient Chiropractic Health History Forms

These forms give Dr. DeFabio an overall history of your health.

Download & Print Form
Back Index
Lower Extremity Index
Neck Index
Upper Extremity Index

Acupuncture New Patient Health History Forms

These forms give Amanda Occhipinti an overall history of your health 

Download & Print Form

Acupuncture Informed Consent 

Download & Print Form

Auto Accident Form

If your health issue is the result of a car accident, we need some additional information.

Download & Print Form

Medicare Patients

If you are a Medicare patient, this information is necessary for processing your claims. 

Download & Print Form
Back Index
Neck Index

Download the Free AdobeReader®