New Patient Paperwork

Vibrant Life Health Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

If pregnant, please fill out both the “Vibrant Life New Patient Form” and the “History for Pregnant Patient” forms.

OFFICE HOURS


Monday
9:00am - 12:00pm
2:00pm - 6:00pm


Tuesday
2:00pm - 6:00pm


Wednesday
9:00am - 12:00pm
2:00pm - 6:00pm


Thursday
2:00pm - 6:00pm


Friday
By Appointment Only


Saturday
Closed

Vibrant Life Health Center
12627 San Jose Boulevard Suite 502
Jacksonville, FL 32223
(904) 683-8177

quoteI’m a big proponent of chiropractic but what I want to tell you today is how special and different     Dr. Jon is from other Chiropractors! His exam is extremely comprehensive. Above and beyond other chiropractors I have used. When I walked in I had very specific pains and when I walked out they were gone! I’m a patient for Life!"

Hector Cisneros       

Vibrant Life Health Center
12627 San Jose Boulevard Suite 502
Jacksonville, FL 32223
(904) 683-8177