Emerald Coast Chiropractic

850-654-1850

Contact Us Now!

850-654-1850

NEW PATIENT ONLINE INTAKE
  • Chiropractic Care
    • Miramar Beach, Destin, and Santa Rosa Beach Chiropractic Care
      • How To Find A Chiropractor Near Me
    • The Chiropractors
      • Ken Whidden, DC
      • J.D. Whidden DC
      • Jessica Whidden DC
    • The Staff
      • Maria Ramos
      • Gloria Whidden
      • Stephanie White
  • Massage Therapy
    • Types of Massage Therapy
    • Cupping
  • Deep Tissue Laser Therapy
    • Deep Tissue Laser Consultations
    • Emerald Coast Chiropractic – Pro Football Legends Affiliate Practice
  • Animal Chiropractic
    • The Power of Animal Chiropractic Care
  • Acupuncture
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  • Contact Us
  • Nutritional Products
    • Standard Process Patient Direct
      • Adrenal Health Daily Fundamentals
      • Bone Health Daily Fundamentals
      • General Female Endocrine Daily Fundamentals
      • General Health Daily Fundamentals
      • Standard Process Purification Program
    • Total Tea
  • Common Conditions
    • Fibromyalgia
    • Lower Back Pain
    • Neck Pain
    • Sciatica
    • TMJ
  • Common Children’s Conditions
    • Colic
    • Bed wetting
    • Frequent colds
    • Ear Infections
    • Scoliosis or curvatures
  • Patient Forms
Home » Patient Forms

Patient Forms

Thank you for considering Emerald Coast Chiropractic as your new partner in health.  Click on the link below to fill in our online intake form.  You can use your desktop computer, laptop, iPad, tablet or even your smartphone!

NEW PATIENT ONLINE INTAKE

***Once your intake is complete, please call our office or utilize our “Contact Us“ page to schedule your appointment!***

 

To fill out our digital New Patient Intake, please click the link below:

NEW PATIENT ONLINE INTAKE
  • New Patient Intake Form

 

For Animal Chiropractic, Sports Physicals or School Entry Physicals, please use the following links.

Please bring the below completed forms to your scheduled office on your first visit.

  • Download, open with Adobe Reader and you may type on these forms, then save and print State of Florida Sports Physical
  • Download, open with Adobe Reader and you may type on these forms, then save and print State of Florida School Entry Physical Form

*All forms can be opened with Acrobat Reader, which is available for free download here.

Monday - Thursday  9-6

Friday  9-12

Massage therapy by appointment

850-654-1850

Miramar Beach Location
 

655 Grand Boulevard, D-103, Miramar Beach, FL 32550

Destin chiropractor, Rock Tape Doc 

Emerald Coast Chiropractic 655 Grand Blvd D-103, Miramar Beach, FL 32550 Phone: (850) 654-1850 © 2025 Emerald Coast Chiropractic | Providing gentle, effective chiropractic care for patients in Destin, Miramar Beach, Santa Rosa Beach, Sandestin, Fort Walton Beach, Shalimar, Mary Esther, Niceville, Eglin Air Force Base, Hurlburt Field, the 30A corridor of South Walton, and beyond in Okaloosa and Walton counties. Log In