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Professional Referral Form

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Professional Referral Form​

You may use the referral form below to provide us with a referral or alternatively, you can simply email information about your client/patient to Dr. Sheely at drrob@sheelychiro.com  with the subject line REFERRAL: John Smith with the client/patient’s name and phone number, and we will contact them to set up an appointment.

CLICK HERE to DOWNLOAD REFERRAL FORM

Middletown Spine and Injury - Sheely Chiropractic

Seamless Patient Referrals for Legal & Medical Professionals

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Your trusted partner in Personal Injury, Workers' compensation, Veterans Community care, Bloodwork-Based Functional Nutritional Counseling,  and Comprehensive Chiropractic care

 

Why Refer to Dr. Robert B. Sheely?

✓ Over 45+ Years of Specialized Experience

  • Extensive experience in trauma-related cases since 1980

  • Fellow, Primary Spine Care (candidate)

  • Member of the prestigious Academy of Chiropractic

  • Comprehensive postdoctoral education in MRI interpretation and spinal biomechanical engineering

 

✓ Comprehensive Personal Injury Expertise

  • Auto injury rehabilitation specialist

  • Workers compensation cases

  • Slip and fall injuries

  • Sports-related trauma

  • Complete diagnostic and treatment capabilities

 

✓ Advanced Diagnostic Capabilities

  • Dual digital inclinometer range of motion testing

  • Algometer pressure threshold device testing

  • Digital muscle device testing 

  • Orthopedic testing for spine and extremities

  • Neurological testing

  • Biomechanical digital X-Ray analysis software

  • MRI interpretation training to overread MRI findings

  • 3D Markerless Digital.Movement Analysis Software

 

✓ Professional Documentation & Communication

  • Detailed initial assessment reports within 24-48 hours

  • Regular progress updates every 30 days throughout treatment

  • Comprehensive final reports with objective findings

  • Direct communication line for case discussions

  • Court testimony experience when needed

 

What We Provide to Referring Professionals

Initial Phase (Within 48 Hours):

  • Complete initial examination report

  • Diagnostic findings and treatment plan

  • Prognosis and expected treatment duration

  • Any immediate concerns or complications

 

Ongoing Communication:

  • Re-Examination progress reports every 30 days (or as requested)

  • Immediate notification of any significant changes

  • Treatment modifications and updates

  • Patient compliance documentation

 

Case Completion:

  • Comprehensive final report

  • Maximum medical improvement assessment

  • Permanent impairment evaluation if applicable

  • Treatment summary with objective outcomes

  • Recommendations for future care

 

Our Comprehensive Services

Treatment Modalities:

  • Chiropractic adjustments and manipulation (soft tissue work, manual therapy, electronic activator adjusting

  • Low-level laser light  therapy

  • Dry needling with gold-plated micro-filament needles

  • Electrical muscle stimulation (EMS)

  • Ultrasound therapy

  • Traction therapy

  • Logan Basic trigger point therapy

  • Vibropercussive therapy

  • Rehabilitative/therapeutic exercises

  • Massage therapy

  • Yoga therapy

 

Specialized Programs:

  • Auto injury rehabilitation

  • Workers compensation care

  • ChiroThin weight loss program (20-25 lbs in 6 weeks)

  • Veterans community care provider

  • Blood-based nutrition counseling

  • Corporate wellness programs

 

Convenient Scheduling & Access

Flexible Appointment Options:

  • Same-day appointments for urgent cases

  • Daily appointments Monday through Friday

  • Extended hours: Monday & Wednesday 9am-7pm

  • Saturday appointments available by request

  • Online scheduling system for easy patient access

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