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forms
Needs to be completed before coming for your scheduled diabetic shoe appointment
Needs to be completed before coming for your scheduled orthotics appointment
Prescription form for doctor to fill out for stockings
Prescription form for doctor to fill out for shoes & inserts
Certificate of Medical Necessity for diabetics to be filled out by doctor
Please complete and return once all services have been completed
Diabetic Footwear Patient Service Evaluation Form
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