Switch to Main Site
Practice Name

Family Life Chiropractic

Social Media
Primary Location
205 N Garden Ave 1st Floor
Clearwater, FL 33755
Phone: 727-447-4647
Fax: 727-443-3195

Office Hours

DayMorningAfternoon
Monday9-12pm3-6pm
Tuesday9-12pm3-6pm
Wednesday9-12pm3-6pm
Thursday9-12pm3-6pm
FridayCLosedClosed
SaturdayClosedClosed
SundayClosedClosed
Main Content

Family Life 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


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 chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, 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!

Download & Print Form



Download the Free AdobeReader®

Want more information?

Fill out the form below or call us at 727-447-4647

Name: *
Email: *
Phone: *

Special Offer

Chiropractic and Nutrition Exam and Consultation Special Offer

a.. Includes your first treatment
b.. Consultation with Dr. Jere
c.. Health and medical history evaluation
d.. Lifestyle and diet evaluation
e.. Full treatment plan, including lifestyle recommendations and diet and supplement plan
f.. Get any questions answered
For only $79. Usual price is $150!

Massage special offer

Take advantage of our therapeutic massage special: (Valid for initial massage only)
One hour massage for $50. Usual price $65.
call 727 447 4647 for an appointment!


*Offer valid for new patients and local residents only. Limited time offer-may be cancelled without notice. The patient and any other person responsible for payment has a right to refuse to pay, cancel payment, or be reimbursed for payment for any other service, examination, or treatment that is performed as a result of and within 72 hours of responding to the advertisement for the free, discounted fee, or reduced fee service, examination, or treatment.

Our Services

We strive to provide complete care for our patients. Learn more about all the services we provide.

View Services

Testimonial

After I dislocated my shoulder, Family Life put me right back together. I know, being a chiropractor myself, that it would have taken three times as long to recover without Family Life Chiropractic. Thanks all!

- Dr. Renatta S., DC

Office Hours

DayMorningAfternoon
Monday9-12pm3-6pm
Tuesday9-12pm3-6pm
Wednesday9-12pm3-6pm
Thursday9-12pm3-6pm
FridayCLosedClosed
SaturdayClosedClosed
SundayClosedClosed

727-447-4647

Neck & Back Pain
Relief Center

Contact

Family Life Chiropractic
205 N Garden Ave 1st Floor
Clearwater, FL 33755
Get Directions
 
  • Phone: 727-447-4647
  • Fax: 727-443-3195
  • Email Us
Newsletter

Newsletter Sign Up










Community Content