Elite Chiropractic Center of Clayton offers patient forms online so they can be completed in the convenience of your own home or office and will save you 30 mins. in our office:
Print forms below and fill out the information. You may email or fax us the printed and completed forms or bring them with you to your appointment. Our fax number is: 919-553-9909 and our email is info@elitecenters.com.
Please download, print and bring with you to your next appointment.
This form is for all new patients filing health insurance, medicare or self pay (cash).
Please download, print and bring with you to your next appointment.
This form is for all new patients filing health insurance, medicare or self pay (cash).
If you have been involved in an auto accident please use the following form to let us know details about the accident and the injuries you received during the accident.
Please bring your police report and any other information that may be helpful to your appointment.
If you have been involved in an auto accident please use the following form to let us know details about the accident and the injuries you received during the accident.
Please bring your police report and any other information that may be helpful to your appointment.
Pacific Emotional Wellness
a soulful and deep approach to therapy
Dr. Jordan Bonham and Dr. Sam Buckley strive for excellence through superior chiropractic treatment, education and patient satisfaction.
We treat ALL types of neck, back, hip, knee, foot conditions, as well as provide revolutionary soft tissue technique for athletic injuries or chronic conditions.
Hours of Operation:
Monday: 7:30am - 12:30pm 3:00pm - 6:00pm
Tuesday: 7:30am - 12:30pm 3:00pm - 6:00pm
Wednesday: 7:30am to 12:30pm
Thursday: 7:30am - 12:30pm 3:00pm - 6:00pm
Friday: 8:30am - 12:30pm
Saturday: Appointment Only
Sunday: Closed