Welcome to the Proformance Therapy Payment web site

Required Fields in Red


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Secure Transaction
Billing Information
First Name:
Last Name:
Company Name:
Country:
Address:
City:
State/Province:
Zip/Postal Code:
Phone Number:
Fax Number:
Email Address:

Additional Information
Account Number:
Statement Date:
Patient First Name:
Patient Last Name:

Proformance Therapy

Question about billing? Please call us at (847) 581.6300.
If this is a medical emergency, please call 911.