Dr. Scott A. Vinci
Chiropractic Physician
Diplomate American Chiropractic Board of Sports Physicians
Fellow International Academy of Medical Acupuncture

15 Bellemeade Ave.

Smithtown, NY 11787

631-979-3613

Patient Forms

In order to expedite your first visit to our office, you can now fill out forms before your appointment. Please speak with one of our staff to determine which forms are appropriate for you.

1.) New Patient Intake form

2.) Existing Patient Intake form

3.) New Patient Insurance form

4.) Existing Patient Insurance form

5.) Notice of Privacy Practice form

6 ) No Fault Patient Information and History form

7.) Patient Workers Compensation form


Completed forms can be returned to our office two ways. Our fax number is 631-979-2847. If you prefer you may email your forms to: [email protected]

Contact Us

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Office Hours

Find Out When We Are Open

Monday:

9:30 am-12:00 pm

3:00 pm-5:30 pm

Tuesday:

Closed

Wednesday:

9:30 am-12:00 pm

3:30 pm-7:00 pm

Thursday:

9:30 am-12:00 pm

3:30 pm-6:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed