Delaware Back Pain & Sports Rehabilitation Centers

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  • Home
  • About Us
    • Legal Concierge
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  • Providers
    • Medical
      • Barry L. Bakst DO
      • Stephen Beneck MD
      • Arnold Glassman DO
      • Anne C. Mack MD
      • Jeffrey S. Meyers MD
      • Rachael Smith DO
      • Craig Sternberg MD
      • Kartik Swaminathan MD
      • Pramod Yadhati MD
      • Irene Fisher PsyD
    • Chiropractic
      • Brian Baar D.C.
      • Kristi Dillon D.C.
      • Mark Farthing D.C.
      • Marjorie Mackenzie D.C.
      • Adam Maday D.C.
      • Hetal Patel D.C.
      • Michael Sharkey, D.C.
      • Riley Tuininga, D.C.
  • Specialties
    • Chiropractic Care
    • EMG/NCS
    • Rehabilitation Therapy
    • Sports Medicine
    • Pain Management Counseling
    • Accident & Injury
    • Workers’ Compensation
    • DOT - CDL Medical Exams
    • Wellness
    • Closed Head Injuries
  • Treatments & Procedures
    • Advanced Non-Surgical Treatments
      • Platelet Rich Plasma Therapy
      • Prolotherapy
      • Laser Therapy
      • Graston Technique
      • Anti-Gravity Treadmill
      • Myofascial Release
      • 3D Active Traction
      • Ultrasound-Guided Injections
    • Interventional Procedures
      • Interventional Pain Management
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Patient Forms

Thank you for selecting Delaware Back Pain & Sports Rehabilitation Centers for your care. To schedule an appointment, please call the office you prefer to visit or use our online appointment request form.

Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Downloadable Forms:

New Patient to our Practice?  Start Here! 

  • New Patient Registration Packet
  • New Patient History Form

Follow-up Visit 

  • Regular Follow-Up V t Form

Are you having an EMG?  

  • New Patient Initial History EMG.pdf

Need to update your DOT Certification? 

  • DOT Medical Clearance Form.pdf  - We have made medical clearance from your treating Physicians EASY!
  • DOT Medical Examination Report Form MCSA-5875 (1)

Informational Forms:

  • Quit Smoking NOW Information Sheet.pdf
  • Prescription_Opioid_Fact_Sheet_Patients.pdf  - What you need to know!

No Surprises Patient Notification
Download the No Surprises Patient Notification here

  • Good Faith Estimate.pdf

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

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Patient Education

Our patient education library features more than 200 award-winning articles with images, videos, and tons of helpful information.

LEARN MORE

Foulk Road
2006 Foulk Road, Suite B
Wilmington, DE 19810
Phone: (302) 529-8783
Fax: (302) 529-7470

Middletown
124 Sleepy Hollow Drive, Suite 204
Middletown, DE 19709
Phone: (302) 376-8080
Fax: (302) 378-1684

Riverside
700 Lea Blvd., Suite 102
Wilmington, DE 19802
Phone: (302) 764-2615
Fax: (302) 762-4076

Smyrna
29 N. East Street
Smyrna, DE 19977
Phone: (302) 389-2225
Fax: (302) 389-1003

Omega
87 Omega Drive, Building B
Newark, DE 19713
Phone: (302) 733-0980
Fax: (302) 733-7495

Eden Hill (Dover)
200 Banning Street, Suite 350
Dover, DE 19904
Phone: (302) 730-8848
Fax: (302) 730-8846

Glasgow
2600 Glasgow Avenue, Suite 210
Newark, DE 19702
Phone: (302) 832-8894
Fax: (302) 832-8897

Milford Office (Air Park Plaza)
915 North DuPont Boulevard, Suite 104
Milford, DE 19963
Phone: (302) 491-4487
Fax: (302) 491-4635

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Staffed by certified physiatrists, chiropractors, psychologists, and therapeutic rehabilitation specialists, we provide pain relief for many types of bone, joint, nerve conditions. Our interventional pain management specialists (PM&R) treat closed head injuries, stroke, concussion, whiplash, dizziness, headaches, sciatica, disc problems, back & neck pain, joint stiffness, sleep apnea, muscle spasm, fibromyalgia, arthritis, neuritis, bursitis, and more.  We also treat job related injuries and injury from auto accident, sports or a fall at home.  As experts in Pain Medicine, our doctors provide surgical and non-surgical solutions including trigger point injections, epidural injections, nerve block, spinal cord stimulation, intrathecal spinal pump implant, PRP therapy, Graston® technique, Prolotherapy and more.  Serving Wilmington, Newark, Middletown, Smyrna, and Dover, Delaware.