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Orthotic Order Form All orthotic orders must be accompanied by a prescription.Date: __/__/___ Referring Physician/Agency___ Physician/Agencys Telephone #:___Patients Name:___ Tel. #:___ Gender: MFAge:___Weight:___Orthotic
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The 'for physicians - r' refers to regulations or reporting requirements that physicians must comply with, often related to financial disclosures or tax filings.
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