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CUSTOM DIABETIC INSERT ACCOMMODATIONS / L5000 ORDER FORM Bill To:Ship To: Recontact Name: PO Number: Phone:(Please Print) Patient Name: Male Female Shoe Size Needed: Accommodations: Metatarsal BarsLeftMetatarsal

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What is custom diabetic insert accommodations?

Custom diabetic insert accommodations are personalized adjustments made to footwear to accommodate diabetic inserts and prevent foot-related complications.

Who is required to file custom diabetic insert accommodations?

Individuals with diabetes who require special footwear accommodations for their diabetic inserts are required to file custom diabetic insert accommodations.

How to fill out custom diabetic insert accommodations?

To fill out custom diabetic insert accommodations, individuals need to provide information about their medical condition, the type of diabetic insert being used, and the specific adjustments needed for their footwear.

What is the purpose of custom diabetic insert accommodations?

The purpose of custom diabetic insert accommodations is to ensure that individuals with diabetes have the proper support and protection for their feet to prevent complications such as ulcers and infections.

What information must be reported on custom diabetic insert accommodations?

Information that must be reported on custom diabetic insert accommodations includes the individual's medical history, the type of diabetic insert being used, and any specific adjustments needed for their footwear.

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