Get New Custom Orthotic Order Form - Acor

Filling out the NEW Custom Orthotic Order Form - Acor online is a straightforward process designed to ensure that you provide all necessary information for your custom orthotics. This guide will walk you through each section of the form to help you complete it accurately.

Follow the steps to effectively fill out the form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Begin by entering your shipping information in the 'SHIP TO' section. Provide the recipient's name, address, city, state, zip code, phone number, fax, and email address.
3. Next, proceed to the 'BILL TO' section and fill in the billing address with the same level of detail as before, including the necessary contact information.
4. In the 'CHOOSE A SHIPPING METHOD' section, select your preferred carrier and shipping option (e.g., FedEx or UPS) and denote your requested ship date and purchase order number.
5. Fill out the 'ABOUT THE PATIENT' section by specifying the patient's name, age, weight, gender, previous experience with Acor custom orthotics, activity level, and diagnosis.
6. If you are not ordering shoes, provide the manufacturer's details, size, width, and toe shape in the section labeled 'IF NOT ORDERING SHOES'.
7. Indicate the type and quantity of orthotics being ordered in the appropriate fields, ensuring to select 'LEFT' or 'RIGHT' for any specific customization requested.
8. For modifications, check the relevant boxes and note any additional instructions as specified in the 'SPECIAL ORTHOTIC INSTRUCTIONS' section.
9. After completing all fields, review your entries to ensure accuracy and completeness.
10. Finally, save any changes made, and download, print, or share the completed form as needed.

Complete your custom orthotic order form online today for a streamlined experience.