Southside Chiropractic & Car Injury Clinic
All fields are required
Type of Visit
Auto Accident Patient
Cash Patient
DOT Physicals
Medicare Patient
Health Insurance Patient
New Auto Accident Patient
New Cash Patient
New Health Insurance Patient
New Slip & Fall
Decompression Patient
Massage Patient 60
New Massage Patient
Workers Compensation
School Physicals
VA Patient
New VA Patient
Video Visit
Office
Southside Chiropractic & Car Injury Clinic
Starke Office
Reason for Visit
e.g. Initial Consultation
Patient name
Firstname Lastname
Date of birth
mm/dd/yyyy
Email
email@example.com
Home phone
(555) 555-5555
Cell phone
(555) 555-5555
Requested time
Select a time below under Available Times
Office Address:
8825 Perimeter Park Blvd, Ste 102 Jacksonville FL 32216
8825 Perimeter Park Blvd, Ste 102 Jacksonville FL 32216
New and Existing patients can make appointments online.
Office Phone:
(904) 497-0823
You must select a date and time for your appointment.
Available Times
Previous Week
Next Week
Visit Length:
10 minutes
Submit Appointment Request
You will receive an email confirmation.
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Action Required: Confirm your appointment