SELF REFERRAL

For patients who wish to see one of our doctors of physical therapy without a referral from a doctor, please complete the forms found at the links below.

770.506.6993

TO APPLY FOR CREDIT

PATIENT FORMS

WE ACCEPT THE FOLLOWING INSURANCE PLANS

To start, click on a link below to view insurance forms

Click on the area to be treated and complete the corresponding form

Copyright 2020. Performance Physical Therapy. All rights reserved.   

MEDICARE AND ALL SUPPLEMENT PLANS (PFFS)

HUMANA GOLD CHOICE

(A MEDICARE SUPPLEMENT PLAN)

COVENTRY'S MEDICARE SUPPLEMENT PLAN


MEDICAL INSURANCE

AETNA

AMERIPLAN DISCOUNT CARDS

BEECHSTREET

BLUE CROSS BLUE SHIELD PPO & PAR

(NO HMO OR POS)

CIGNA (ALL PLANS)

COVENTRY (ALL PLANS)

FIRST HEALTH

GA 1ST

HUMANA PPO, HMO, POS

PRIVATE HEALTHCARE SYSTEMS (PHCS)

TRICARE FOR LIFE AND STANDARD (NO PRIME)

UNICARE

UNITED HEALTHCARE

​UNIVERSAL HEALTHCARE


ALL WORKER'S COMPENSATION