If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site


You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Ridgefield Performance Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

Dr. Zeitler is in-network with most major insurers with the exception of Cigna.  For those insurance companies that Dr. Zeitler is not in-network we would be more than happy to bill your insurance company for out-of-network services or accept cash payment (please call for rates). 

Registration Forms

Please give 24 hours notice for all cancellations.  This enables us to rebook appoinments.  For those patients who cancel without giving 24 hours notice there will be a $50 charge. 

Download the Free AdobeReader®