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Online Forms Middle Island Chiropractor

Lupo Saladino Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • 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 us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Assignment of benefits form-if you have insurance you will be assigning benefits to our office so we can bill your insurance directly.



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Location

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Office Hours

Our Regular Schedule

Middle Island

Monday:

Closed

Tuesday:

10:00 am-1:00 pm

3:00 pm-7:00 pm

Wednesday:

Closed

Thursday:

Closed

Friday:

10:00 am-1:00 pm

3:00 pm-7:00 pm

Saturday:

By Appointment

Sunday:

Closed

Testimonial

  • "Excellent! Attentive and professional. Both doctors are great! The entire family uses this practice"
    Lorraine V. / Middle Island, NY