Partner Program
Patient Order Form
The final section allows you or the patient to place a secure order online.
Receipts will be immediately emailed to you and the patient once the order is submitted.
Within 1 business day they will receive two more emails with tracking information for the foot mold impression kit.

Partner Program
Patient Order Form
The final section allows you or the patient to place a secure order online.
Receipts will be immediately emailed to you and the patient once the order is submitted.
Within 1 business day they will receive two more emails with tracking information for the foot mold impression kit.