Patient Paperwork

Path to Wellness Clinic of Chiropractic provides our patient form(s) online, allowing you to conveniently complete them in the comfort of your own home or office.

All forms are available as PDF files, and AdobeReader® is required to view them.
If you don't have AdobeReader® installed on your computer, you can download it by clicking here.
Simply download the required form(s), print them out, and fill in the necessary information.
Remember to bring the completed form(s) to your appointment.

Download New Patient Paperwork

* Cash or Insurance patients fill this out

Download Auto Accident Paperwork

* Auto Accident patients fill this out

Download Prenatal Intake Form

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Office Hours

Monday

9:00am - 12:00pm

3:00pm - 6:00pm

Tuesday

2:00pm - 6:00pm

Wednesday

9:00am - 12:00pm

3:00pm - 6:00pm

Thursday

9:00am - 12:00pm

3:00pm - 6:00pm

Friday

9:00am - 12:00pm

Saturday

CLOSED

Sunday

CLOSED

Path to Wellness Clinic of Chiropractic

3535 Hwy 17 Suite 11

Fleming Island, FL 32003

904-644-8100

New Patient Special

New to the office? Take advantage of our Special Offer!

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"I've been under the care of Dr. Chitra for the past two years, and I can't express enough how grateful I am for her expertise. Working in a warehouse involves constant heavy lifting, and Dr. Chitra has been instrumental in keeping my back in great shape. Her skillful approach and dedication has helped me tremendously. I highly recommend Dr. Chitra for anyone seeking effective and compassionate chiropractic care."

Corey Burgos

"Dr. Chitra is a great doctor and leads a great team. While under her care after being rear ended in a car accident, I felt a great deal of relief after few treatments, and I can do more everyday things that I was not able to right after the accident."

Charlie Smith

"For the past 3 months, I've been dealing with bad back pain to the point where it was difficult to stand for my job as a scrub technician. I started seeing Dr. Chitra and she started adjusting my back. My pain started going away and I am able to perform my duties without having to sit down for relief. I would definitely keep coming back for more adjustments."

Daniella Clarke

Path to Wellness Clinic of Chiropractic

3535 Hwy 17 Suite 11

Fleming Island, FL 32003

904-644-8100