New Customer Order Form

New Customer Customized Orthotic Order
Fields marked with an * are required
New Customer Question * If you have walked across our pressure plate please answer the next question. If you have not walked across our pressure plate skip the next question and be sure to add a fit kit to your order when checking out.
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Sex *
Shoes or boots worn most often
Do you suffer from any of the following problems
Do you suffer from any of the following conditions
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What type of insole do you want *

You will be directed to the insole cart page after submission.

 

We Accept
HSA - FSA - Medical Savings Accounts

100% MONEY BACK GUARANTEE, 3 YR WARRANTY