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Online Forms

Ju Chiropractic Wellness Center offers our patient form(s) online so they can be completed 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.

Auto Injury Patients Should Complete:

Download & Print Form


Minors(Children) Patients Should Complete:

Download & Print Form


All Other Patients Should Complete:

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

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Request Information

THIS ---->https://juchiropractic.chiromatrixbase.com/for-new-patient/online-forms.html

Office Hours

DayMorningAfternoon
Monday9:00am-11:30am2:00pm-6:00pm
TuesdayClosed2:00pm-6:00pm
Wednesday9:00am-11:30am2:00pm-6:00pm
ThursdayClosed2:00pm-6:00pm
Friday9:00am-11:30am2:00pm-6:00pm
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00am-11:30am Closed 9:00am-11:30am Closed 9:00am-11:30am Closed Closed
2:00pm-6:00pm 2:00pm-6:00pm 2:00pm-6:00pm 2:00pm-6:00pm 2:00pm-6:00pm Closed Closed

Dr. Ju has been a lifesaver. After spending years going to different doctors trying to treat my symptoms, I finally found someone to understand and treat the cause. It has taken years to cause my problems and I have had to be patient during my rehab but I have gone from excruciating pain in my neck to feeling great and healthy. Thanks Doc! 

Rich S.
Raleigh, NC

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