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Date
Day
Month
Year
Orthotic length
Heel Design
Density
Arch Style
Arch Fill
Standard Options
All padding is 3mm as standard unless otherwise specified
Heel cup depth is 10-12mm as standard unless otherwise specified
Device is 2mm thick as standard unless otherwise specified
Arch height measured from rear foot zero
Heel expansion is 3-4mm as standard unless otherwise specified
If no scans are sent, standard arch height will be made at 31mm as standard unless otherwise specified
Heel lifts completed as long rather than short as standard unless otherwise specified
Modifications LEFT
Modifications RIGHT
Intrinsic Padding LEFT
Intrinsic Padding RIGHT
Top Cover - Please note extra Charge
Orthotic Print Colour
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