Online Admitting 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.


Patient Intake Forms

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
   Download & Print Form

Back and Leg Symptoms History

Include the following form if you are experiencing back and/or leg pain.
 Download & Print Form

Neck and Arm Symptoms History

Include the following form if you are experiencing neck and/or arm pain.
 Download & Print Form


Dr. Mark DeMalio | (330) 652-5600 | 1250 Youngstown-Warren Rd., Niles, OH


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.

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Dr. DeMalio Asks some important questions of interest to Trumbull County residents - Chiropractor Trumbull County Dr. DeMalio Asks...

What does a chiropractic adjustment do?
Chiropractic adjustments give your spine a little "nudge" at the right place, right time and the right direction so your body can use that energy to "right" itself. With a schedule of consistent chiropractic visits, a new, healthier spinal pattern emerges.
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 Trumbull County chiropractic practice.