Performance Wellness 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.


Required Forms for First Chiropractic Visit

Patient Intake
Performance Wellness Welcome
Performance Wellness Financial Responsibility
Performance Wellness Consent to Services

Optional Forms

Auto Accident
Personal Injury Consent
Personal Injury Financial

Massage Forms

Required forms for First Massage Visit
Client Info 
Appointment Cancellation Policy 

Termination of Performance Club membership
Performance Club Cancellation Form


United Health Care, American Chiropractic Network

ACN Group


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!

Download & Print Form


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Free Injury Clinic
Wondering if you need stretching, strengthening, or treatment?  Our doctors will provide a free injury evaluation, perform ART treatment if needed, and give advice about how to best treat the pain.
2nd and 4th Wednesdays, 6:15 - 6:45pm
Jack and Adam's Bicycle Shop
1210 Barton Springs Road
Come see us before you have to!

 

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Contact

Performance Wellness
6500 North Mopac, Bld. 3, Ste. 3101
Austin, TX 78731
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  • Phone: 512-491-7772
  • Fax: 512-339-6806
  • Email Us
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