Chiropractic Invoice Template
A chiropractic invoice template for adjustments, examinations and x-rays by visit date, with treatment plan packages. Example amounts are illustrative — replace them with your own.
Also used as a chiropractor invoice, chiropractic bill, chiropractic care invoice.
From
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Invoice
| Invoice # | INV-001 |
| Issued | Oct 8, 2026 |
| Due | Oct 22, 2026 |
Billed to
| Description | Qty | Rate | Amount |
|---|
| Subtotal | $0.00 |
| Tax (0%) | $0.00 |
| Total due | $0.00 |
Notes
Payment due within 14 days. Thank you for your business!
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When to use this template
Use it for chiropractors billing patients and attorneys on injury cases.
Fields to include
- Your business name, address and contact details
- Invoice number, issue date and due date
- Patient name and visit dates
- Procedures by visit
- License number and claim details
Sample chiropractic invoice: what the lines look like
- New patient examination1 × $120.00 = $120.00
- Spinal adjustment (visits)6 × $55.00 = $330.00
- X-rays, two views1 × $90.00 = $90.00
- Example total before tax$540.00
Practical tips
- List visits individually for injury claims.
- Show plan discounts as a line.
- Add codes when the invoice supports a claim.
Frequently asked questions
How do chiropractors bill treatment plans?
A package price for a set number of visits, paid up front or monthly, with each visit recorded as it is used.
What about personal injury cases?
Bills are often held until the case settles under a lien. Keep itemized invoices by date of service.
Can I add my logo and tax to this chiropractic invoice?
Yes. Upload a logo, set a tax rate and a discount if you need them, and the totals update as you type. The PDF matches the preview.
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