New Patient Forms – Revive Chiropractic & Wellness, Jacksonville FL

Welcome to Revive Chiropractic & Wellness! To make your first visit smooth and efficient, please complete our new patient intake forms online before your appointment.

If you haven’t already scheduled your visit, please call our Jacksonville chiropractic office at (904) 996‑2243 to set up your appointment after submitting your forms.

✅ Completely Paperless – No printing required
✅ Secure Online Submission – Your completed forms go directly to our office
❗ Important: Our full New Patient Form can be completed on a laptop, desktop, or mobile device
📱 The Environmental Risk Evaluation Form uses a holistic questionairre to discovering multiple areas of dis-ease in your life and evaluates diet, exercise, sleep, stress, hormones, and more. This is not required but is an excellent tool.

Click the link below to begin your online chiropractic intake forms today. We look forward to helping you feel better, naturally.