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) 856-5799 | 1552 North Road SE #202, Warren, 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's the difference between sick care and health care?
Sick care is largely about relieving or suppressing symptoms. Health care is about improving performance. While sick care is about how you feel, health care is about how you function. Sick care is what you do to treat an obvious problem, and health care is what you do to avoid the problem and advance your well-being.
Can chiropractic cure a child's ear infections?
Chiropractic isn't a cure for anything. Nor is it a treatment for ear infections. However, many children who suffer with ear infections also suffer from spinal problems in their neck, compromising nerves to the ear, depressing the immune system and preventing proper drainage. Can chiropractic help? Find out!