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Therapeutic Shoes for Diabetes
Permission to Release Medical Records (recent foot exam)
Permission to Release Medical Records (recent diabetes exam)
Statement of Certifying Physician
The process starts with a foot exam and prescription.
Fill out the patient registration if you are a new patient.
For fastest turn-around, request that recent clinical progress notes from both your foot exam and your diabetes exam be faxed to Boston Pedorthic at 270-747-8779. Alternatively, you can click on each release above, fill it out, print and sign, take a picture and then text them to 617-787-8779.
When we have received your documents, we will call you to schedule an appointment.
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