Foam Foot Orthotics

Foam Foot Order Details
Clinician*
Contact Phone
Contact Email*
Due Date*
- Standard Turn Around
- Rush Order (25% rush order fee applies)
Date
MM slash DD slash YYYY
Patient name/ID*
Side*
- Left
- Right
- Bilateral
Foot has been partially amputated
- No
- Yes
Model Details*
- I am providing a MODIFIED scan
- I am providing an UNMODIFIED scan
- I am posting a crush box
- I am posting a modified plaster model
Scan File
Accepted file types: stl, cvx, o01, obj, ply, vsrf, Max. file size: 2 MB.
We will accept scans in the following formats: .stl .cvx .o01 .obj .vsrf .ply
Corrections
Corrections Identical Both Sides
- Yes
- No
Cast Corrections Left or Both Sides
Metatarsal Bar*
- No
- Yes
Metatarsal Dome*
- None
- Small
- Large
Arch Loading*
- None
- High Loading
- Low Loading
Heel Post*
- None
- Post Medially
- Post Laterally
Heel Post Angle*
Ray Relief
- None
- 1st Ray
- 2nd Ray
- 3rd Ray
- 4th Ray
- 5th Ray
Specific Off-loading Sites
Cast Corrections Right Side
Metatarsal Bar (R)*
- No
- Yes
Metatarsal Dome (R)*
- None
- Small
- Large
Arch Loading (R)*
- None
- High Loading
- Low Loading
Heel Post (R)*
- None
- Post Medially
- Post Laterally
Heel Post Angle (R)*
Ray Relief (R)
- None
- 1st Ray
- 2nd Ray
- 3rd Ray
- 4th Ray
- 5th Ray
Specific Off-loading Sites (R)
Manufacturing Details
Upper Layer Material*
Base Layer Material*
Arch Fill Material*
Top Cover Material*
Poron Spot Padding?
Trim Length of Orthosis (cm)*
Additional Information

Australia’s first Orthotic & Prosthetic manufacturing facility offering central fabrication and carving using industry-leading CAD/CAM technologies.

Foam Foot Order Details