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New Practice Member Paperwork

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

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

printerAdult Health Questionnaire  - Click Here to Download

 

printerTerms of Acceptance - Click Here to Download

 

printerPhoto Authentication - Click Here to Download

 

printerQuadruple Visual Analogue Scale - Click Here to Download

 

printerPediatric Intake Form (Newborn) - Click Here to Download

 

printerPediatric Intake Form (Infant) - Click Here to Download

 

printerPre-School Child History - Click Here to Download

 

printerSchool Aged History - Click Here to Download

OFFICE HOURS

Monday,  Wednesday, Thursday

7:30am - 6:00pm

Chiropractic Oneida NY Office Logo

Lombardi Chiropractic
1116 Upper Lenox Avenue
Oneida, NY 13421
(315) 363-4114

CNY Wellness Movement
Recommended Chiropractor

WHAT OUR PRACTICE MEMBERS SAY

“I've always have poor posture and it has affected me in major ways. I just wasn't comfortable. Since coming here, I've notice that I don't get the uncomfortableness anymore."

- Kim P.

“I was in excruciating back pain and I struggled along for about 5 years. I would hardly be able to move. I decided I needed to do something. I came to see Dr. Pete and within a month he had taken care of all of my back pain.”

- Jess

“I had suffered from migraines for a majority of my life. It was to the point where it affected my life and I couldn't get out of bed. Within three weeks my migraines subsided and I can't tell you the last time I had one. It has changed my life.”

- Melissa T.

Recommended Chiropractor - White

1116 Upper Lenox Avenue

Oneida, NY 13421