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Personal Custom Orthotics Customizer

 

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Personal Custom Orthotics Customizer

For people who are not sure which orthotics to choose, we have this Personal Custom Orthotics Customizer. With more than 40 years experience as a leading orthotic laboratory, we realize that you have a large selection of Custom Orthotics for your individual foot needs.

Let us assist you in choosing the performance orthotics for your needs.

Please fill out this Personal Custom Orthotics Customizer and click Submit. One of our Doctors will contact you to discuss your issues and recommend the appropriate orthotics.

Doctors Orthotics 888-353-7834

First Name*

Last Name*

Home Phone (xxx)-xxx-xxxx *

Work Phone

Best Time To Reach *

Email*

How Old Are You? *

How Tall Are You?*

What Is Your Weight? *

Male Or Female?*

How Many Hours A Day Are You On Your Feet? *

What Type Of Shoes Do You Wear Daily? *

Are Your Feet Wide Or Normal? *

Do You Have Plantar Fasciitis Or Morton's Neuroma? *

Do You Have Heel Pain?
YesNo

Do You Have Arch Pain?
YesNo

Do You Have Ball Of Foot Pain?
YesNo

Do You Have Back Pain?
YesNo

Questions Or Comments