Patient Forms

 

New Patients (Adult):
 

Wellspring New Patient Form


Click on the link above to access our New Patient Forms. We ask that you would complete this form before arriving to your first visit. The process will take about 10-15 minutes of your time but will be helpful to the Wellspring Health and Sports Performance staff and make your initial consultation time shorter.

Instructions: Please save the PDF form to your computer and simply print to fill out.

You will be asked to sign a hard copy of the forms when you arrive at our office. Once the forms have been completed, please fax them to 904-249-1530 or bring them to our office for your first visit. Questions? Call our office at 904-249-1551 to speak to a staff member.

New Patient (Children):
 

Wellspring New Patient Children's Form


Click on the link above to access our New Patient Forms. We ask that you would complete this form before arriving to your first visit. The process will take about 10-15 minutes of your time but will be helpful to the Wellspring Health and Sports Performance staff and make your initial consultation time shorter.

Instructions: Please save the PDF form to your computer and simply print to fill out.

You will be asked to sign a hard copy of the forms when you arrive at our office. Once the forms have been completed, please fax them to 904-249-1530 or bring them to our office for your first visit. Questions? Call our office at 904-249-1551 to speak to a staff member.

Auto-Accident Patients:

Wellspring Auto-Accident Intake

Click on the link above to access our Automobile Accident Patient Forms. We ask that you would complete this form before arriving to your first visit. The process will take about 10-15 minutes of your time but will be helpful to the Wellspring Health and Sports Performance staff and make your initial consultation time shorter.

 

Instructions: Please save the PDF form to your computer and simply print to fill out.

 

You will be asked to sign a hard copy of the forms when you arrive at our office. Once the forms have been completed, please fax them to 904-249-1530 or bring them to our office for your first visit. Questions? Call our office at 904-249-1551 to speak to a staff member.


 

Our Pledge for Your Total Wellness

 

Evaluation and treatment

  •     Personalized health care

  •     Pain reduction as quickly as possible

  •     Referral to a specialist (if needed)


Education in proper wellness care

  •     Exercises and stretching

  •     Likely period of recovery to full health

  •     Nutritional supplementation

  •     FREE Health seminars to educate patients about the body


Your privileges as a patient are:


Understanding how what you do affects your health

  •     Your activity level

  •     Nutritional needs

  •     Pain relief and preventive maintenance


Integration of Treatments:


A professional who utilizes a wholistic approach to your health condition with:

  •     Acupuncture

  •     Chiropractic 

  •     Neuro Muscular Therapies

  •     Rehabilitation


Participating in a health-supporting lifestyle

  •     Purposeful exercises to maintain strength

  •     Stretches to promote full movement and coordination

  •     Professionally recommended nutritional supplements


Together, we can achieve your maximum wellness and enjoyment of life!

Call Wellspring Health & Sports Performance at (904) 249-1551 to schedule an appointment to begin your customized plan.

 

 

Make an Appointment

710 3rd Street North
Jacksonville Beach, FL 32250

 

Tel: 904.249.1551

Fax: 904.249.1530

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