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.

Chiropractic New Patient Health History Forms

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

New Patient Forms 
Back Index
Lower Extremity Index
Neck Index
Upper Extremity Index

Psoriasis New Patient Health History Forms

These forms give Dr. DeFabio an overall history of your health. Please fill out ALL forms listed below

2023 New Patient forms

CAAB-25 Questionnaire

Histamine Intolerance Questionnaire
Diet Diary


Auto Accident Form

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

 Auto Accident Patient Forms


Medicare Patients

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

ADDITIONAL Medicare New Patient Form
Back Index
Neck Index



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