Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


New Patient Intake Form

Welcome to our online New Patient Intake Form. The information you fill in will be sent directly to our office, speed up your office visit, and will help us to better serve your healthcare needs. Please take a moment to click on the link below and completely fill out this form, and upon completion of all form categories click the [Submit] button at the bottom of the form.

New Patient Intake Form

 


 

Consent to Initiate Care

 Download & Print Form


The 9 Day Cleanse Personal Analysis Form

 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.



Dr. Daryl Gioffre| Phone: (212) 472-5558
16 East 79th Street, Suite G4, New York, NY

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Stress Management

 Dr. Daryl Asks some important questions of interest to New York residents - Chiropractor New York Dr. Daryl Asks...

How could a child benefit from chiropractic?
Regardless of our age, each of us in New York encounters physical, chemical and emotional stresses that exceed our ability to handle. For newborns, it could be the trauma encountered at birth. For toddlers it could be from learning to walk or ride a bike. Many of the problems we chiropractors see in adults are the result of neglected traumas from childhood.
Is a muscle spasm a cause or an effect?
With the knee-jerk use of muscle relaxers, you'd think it was a cause. But it's an effect. Chiropractors know that bones don't move unless muscles move them. And muscles don't contract unless commanded by the nervous system. That's why your nervous system is the focus of our New York chiropractic practice.