Chiropractic Care for the
Whole Family

Our Platinum Care Promise

“If we can’t help you, we will find a doctor who can.”

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 fax us the printed and completed form or bring it with you to your appointment.
Our fax number is: 919-553-9909
We are welcoming new patients from Clayton and the surrounding areas. Please contact us today to schedule an appointment.

New Patient Health History Forms:

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!

Please see PDF links below to download patient forms.

New Patient Auto Accident Form:

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.

Auto Accident Patient Forms

Thumbnail 220x PDF
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.

Download "2016_MVA-PI_PAPERWORK.pdf"

Spanish Auto Accident Patient Forms

Thumbnail 220x PDF
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.

Download "NP_MVA_Spanish.pdf"

Consent to Treat a Minor Form for Parent: