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FAX OR EMAIL COMPLETED FORMSFUNCTIONAL FOOT ARTHROSIS /Date (dd/mm/by)Fax 866.700.7837 | Email orders@surestep.net | Phone 877.462.0711/PATIENTFABRICATIONLast Name/Patient ID Weight bearing foam impressionist
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How to fill out functional foot orthosis

01
Start by selecting the appropriate size and design of the functional foot orthosis based on the patient's needs and foot structure.
02
Have the patient stand or sit in a comfortable position with their feet flat on the ground.
03
Place the functional foot orthosis inside the shoe with the flat side facing down and the arch support positioned under the arch of the foot.
04
Ensure that the orthosis is positioned correctly and provides adequate support and comfort for the patient.
05
Have the patient wear the shoes with the functional foot orthosis for a few hours each day initially, gradually increasing the wearing time as needed.
06
Monitor the patient's comfort and gait while wearing the functional foot orthosis, and make any adjustments as necessary to optimize the fit and support.

Who needs functional foot orthosis?

01
Functional foot orthosis is recommended for individuals who suffer from foot pain, plantar fasciitis, flat feet, high arches, diabetic neuropathy, arthritis, or other foot conditions that require additional support and stability.
02
Athletes and active individuals who engage in high-impact sports or activities may also benefit from using functional foot orthosis to prevent injuries and improve performance.
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Functional foot orthosis is a custom-made or prefabricated device that is worn inside the shoe to correct biomechanical foot problems and improve overall foot function.
Functional foot orthosis is typically prescribed and fitted by a medical professional such as a podiatrist, orthopedic surgeon, or physical therapist.
To fill out a functional foot orthosis, a medical professional will assess the patient's foot condition and create a customized or prefabricated orthotic device accordingly.
The purpose of functional foot orthosis is to correct foot deformities, provide support and stability, alleviate pain, and improve gait and overall foot function.
The information reported on functional foot orthosis includes the patient's name, date of birth, foot condition diagnosis, type of orthosis prescribed, and any specific recommendations for wear and care.
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