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Online Forms

Jupiter Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form (Adult)

Download & Print Form (Child)


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Office Hours

Monday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Tuesday:

Closed

Wednesday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-12:00 pm

2:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "I came into this office, almost a cripple.
    But with Dr. Helia's care over the last few months, I feel like I can twist, turn, and walk without much effort. Dr. Helia is truly a professional."
    Charles G.
  • "I have had some pretty severe injuries and broken many bones (including some in my spine) so I have received chiropractic care before- but nothing like this! No generic adjustments- Dr. Helya will adjust specific vertebrae depending on what I have going on at the time and what my goals/treatment concerns are. I also admire that she relies on X-rays, Thermography, and postural assessments to determine what is going on in the body. I highly recommend her to anyone seeking health, balance, alignment, and long-term results."
    Tiffany L.