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Jernigan Chiropractic Clinic offers our patient form(s) online so you can complete it in the convenience of your own home or 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 Form
New Patient (Accident)
New Patient (Work comp)
Re-exam form

Exclusive Offer

New patients receive 15% OFF first visit.

THIS ---->https://jerniganchiro.chiromatrixbase.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday8:00-12:002:00-5:00
Tuesday8:00-12:002:00-5:00
Wednesday8:00-12:002:00-5:00
Thursday8:00-12:002:00-5:00
Friday8:00-12:002:00-5:00
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00-12:00 8:00-12:00 8:00-12:00 8:00-12:00 8:00-12:00 Closed Closed
2:00-5:00 2:00-5:00 2:00-5:00 2:00-5:00 2:00-5:00 Closed Closed

Reviews

I was in an accident several years ago. It led to chronic neck and low back pain and I had headaches every day. Dr. Jernigan helped me get out of pain and stay out of pain

M. Smith
Gulfport, MS

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