We Do Things Differently

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Wellness Restored Through Therapy

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Years of Successful Work and Dedicated

Step Into a Healthier Life with Confidence

Congratulations on taking the first step toward better health and vitality. At Scardino Family Chiropractic, we don’t just treat symptoms; we create custom care plans that improve your life long-term. Every patient is welcomed personally, and your journey begins with understanding your unique needs.

Download New Patient Forms

Your First Consultation

Before any treatment begins, you will meet with Dr. Scardino for a comprehensive consultation. This ensures that we fully understand your health goals and determine if our approach is the right fit for you.

Download New Patient Form

Dr. Gary T. Scardino | 319 South State Street, Newtown, Pa 18940 | 215-860-7275

Scardino Family Chiropractic Center

Thank you for choosing our practice for your chiropractic needs. Please complete this form in link. If you have any questions or concerns, do not hesitate to ask for assistance. We will be happy to help.

Patient Information

Name

Date

SS/HIC/Patient ID#:

Address

Street Address

City

State

ZIP Code

Sex:

Male

Female

Date of birth

Email *

Home Phone:

Cell Phone:

Work Phone:

Do you prefer to receive calls at:

Partnered for ____ years

Patient Employer/School:

Occupation:

Employer/School Address:

State

City

Zip Code

Spouse/Parent’s Name:

Employer:

Work Phone:

Whom may we thank for referring you to us?

Person to contact in case of emergency:

Phone:

Responsible Party

Name of the person responsible for this account:

Relationship to Patient:

Phone:

Address:

City:

State:

Zip Code:

Name of Employer:

Work Phone:

Insurance Information (Please bring your insurance card to office)

Name of Insured:

Relationship to Patient:

Birthdate:

Social Security#:

Date Employed:

Name of Employer:

Work Phone:

Address:

City:

State:

Zip:

Insurance Co.:

Group#:

Employer#:

Insurance Co. Address:

City:

State:

Zip:

How much is your deductible?

How much have you used?

Max. annual benefit?

DO YOU HAVE ADDITIONAL INSURANCE?

Yes

No

IF YES, PLEASE COMPLETE THE FOLLOWING:

Name of Insured:

Relationship to Patient:

Birthdate:

Social Security#:

Date Employed:

Name of Employer:

Work Phone:

Address:

City:

State:

Zip:

Insurance Co.:

Insured Phone:

Group#:

Insurance Co. Address:

State:

Zip:

How much is your deductible?

How much have you used?

Max. annual benefit?

Daily Habits

What type of exercise do you perform on a daily basis?

None

Moderate

Heavy

What do your daily work habits include? (ex: sitting, standing, light labor, heavy labor, computer work)

What vitamins do you currently take?

What kind of other nutritional supplements do you take (if any)?

Do you smoke?

Yes

No

How much per day?

How much liquor do you consume on a weekly basis?

How much coffee or caffeinated beverages do you consume on daily basis?

Certification & Assignment

To the best of my knowledge, the above information is complete and correct. I understand that it is my responsibility to inform my doctor if I, or my minor child ever have a change in health.

I certify that I, and or my dependent(s) have insurance coverage with _________________________name of insurance company and assign directly to Dr. ______________________ all insurance benefits, if any, otherwise payable to me for services rendered. I understand that I am financially responsible for all charges whether or not paid by insurance. I authorize the use of my signature on all insurance submissions.

The above-named doctor may use my health care information and may disclose such information to the above-named Insurance Company(ies) and their agents for the purpose of obtaining payment for services and determining insurance benefits or the benefits payable for related services. This consent will end when my current treatment plan is completed or one year from the date signed below.

Signature of Patient, Parent, Guardian or Personal Representative

Date

Please print name of Patient, Parent, Gaudian or Personal Representative

During your consultation, you can expect

Discuss your personal health history and current stress factors

Complete an assessment to confirm if you are a suitable candidate

Perform an exam only if it will genuinely benefit your health

Care Customized to Your Needs

If your case is accepted, a follow up report is scheduled (included in the exam cost). This ensures you fully understand your results before starting care.

At the follow up report:

Dr. Scardino explains your findings in clear, simple terms
Provides a detailed, personalized care plan
Reviews the time, frequency, and cost of your care
Encourages including a spouse or family member if needed

Our Commitment to Lasting Recovery

We focus on corrective care that delivers lasting results, not temporary fixes. Our protocols restore function, enhance wellness, and help you live life to the fullest.

Why our care stands out:

Unique life-enhancing and rehabilitative techniques
Addresses root causes, not just symptoms
Dr. Scardino’s personal dedication to your recovery

Expertise Backed by Decades of Experience

Dr. Scardino brings over 30 years of health and wellness expertise and continually updates his skills with the latest methods. Patients receive modern, science-based care designed for safety and effectiveness.

Custom Programs for Maximum Results

Every patient receives a program tailored to their unique needs, helping them reach peak health potential.

Our Programs Include:

Gentle Chiropractic Adjustments

Safe, precise adjustments to restore nerve function and overall wellness.

Range of Motion Exercises

Quick, full-body workouts that strengthen muscles and improve posture.

Personalized Nutrition Testing

Personalized supplement plan to support organs and natural recovery.

Personalized Nutrition Testing

Auriculotherapy and low-level laser treatments for faster healing and pain relief.

Start Your Journey to Better Health

From your first consultation to your personalized plan, we guide you every step.

Experience gentle, science-backed techniques, receive a personalized evaluation, and enjoy improved energy and wellness.

Book Your Consultation Today

Your trusted partner in Chiropractic Care, and Rehabilitation. We focus on Healing, Recovery, and Enhancing your well-being every step of the way.

Your trusted partner in physiotherapy, chiropractic care, and rehabilitation. We focus on healing, recovery, and enhancing your well-being every step of the way.

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We Do Things Differently

Step Into a Healthier Life with Confidence

Download New Patient Forms

Your First Consultation

Before any treatment begins, you will meet with Dr. Scardino for a comprehensive consultation. This ensures that we fully understand your health goals and determine if our approach is the right fit for you.

During your consultation, you can expect

Discuss your personal health history and current stress factors

Complete an assessment to confirm if you are a suitable candidate

Perform an exam only if it will genuinely benefit your health

Care Customized to Your Needs

At the follow up report:

Our Commitment to Lasting Recovery

Why our care stands out:

Expertise Backed by Decades of Experience

Custom Programs for Maximum Results

Our Programs Include:

Gentle Chiropractic Adjustments

Safe, precise adjustments to restore nerve function and overall wellness.

Range of Motion Exercises

Quick, full-body workouts that strengthen muscles and improve posture.

Personalized Nutrition Testing

Personalized supplement plan to support organs and natural recovery.

Personalized Nutrition Testing

Auriculotherapy and low-level laser treatments for faster healing and pain relief.

Start Your Journey to Better Health

Experience gentle, science-backed techniques, receive a personalized evaluation, and enjoy improved energy and wellness.

Your trusted partner in Chiropractic Care, and Rehabilitation. We focus on Healing, Recovery, and Enhancing your well-being every step of the way.

Your trusted partner in physiotherapy, chiropractic care, and rehabilitation. We focus on healing, recovery, and enhancing your well-being every step of the way.

Links

Contact

Scardino Family Chiropractic Center, 319 South State Street, Newtown, PA 18940

[email protected]

(215) 860-7275

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Chiropractic Website and Content.