4425 Treat Blvd. Suite B Concord, CA 94521

Online Forms

Performance Chiropractic 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 appropriate form(s) depending on your insurance or type of case. 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.

Cash Patient Forms - Required (if applicable)

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


Workers Comp. Patient Forms - Required (if applicable)

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


General Insurance Patient Forms - Required (if applicable)

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


Automobile/Personal Injury Patient Forms - Required (if applicable)

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


Kaiser Members/ASHP Patient Forms - Required (if applicable)

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


Medicare Patient Forms - Required (if applicable)

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


Spanish Forms - Required (if applicable)

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


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CONTACT US TODAY

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Location

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Office Hours

Our Regular Schedule

Monday:

9:00 am-12:00 pm

2:30 pm-6:00 pm

Tuesday:

2:30 pm-6:00 pm

Wednesday:

9:00 am-12:00 pm

2:30 pm-6:00 pm

Thursday:

9:00 am-12:00 pm

2:30 pm-6:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed