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 New Patient Health History Form

La Ruffa Chiropractic & Sports Rehab offers our patient forms 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 forms, print them out, and fill in the required information.
  • You may bring them with you to your appointment or email/fax us the completed forms.

This informs us of the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your health.

Download & Print Form


Notice of Privacy Practices

Please review the privacy practices of our office so that you know how your health information is protected and how it can be used.


Download & Print Form

Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!



Download the Free AdobeReader®

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