Patient Forms

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.

New Patient Paperwork

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).

New Patient Paperwork in Spanish

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).

Motor Vehicle Accident New Patient

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.

Motor Vehicle Accident New Patient Form in Spanish

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.

Consent Minor New Patient Form

If your family member who is presenting for treatment is younger than 18, please print and bring in the following completed form.

Pacific Emotional Wellness

a soulful and deep approach to therapy

 

 

· · · San Luis Obispo, California · · ·

Welcome to Elite Chiropractic
Center of Clayton!

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.

Call Elite Chiropractic Center of Clayton today!

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

1411 Marsh St. Ste 206,

San Luis Obispo, CA 93401

805-234-8007 info@pacificemotionalwellness.com

 

Contact information:

8928 US 70 Bus. Hwy W Suite 700
Clayton, NC 27520

Phone: (919) 553-5505

Fax: 919-553-9909

 

Elite Chiropractic Center of Clayton • Dr. Jordan Bonham Clayton • Dr. Sam Buckley Clayton • Clayton Chiropractic Center • Chiropractic Treatment • Chiropractors • Johnston County • NC • Neck Pain • Back Pain • Massage Therapy • Hip Pain • Knee Pain • Soft Tissue Damage • Car Accident • Athletic Injury