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how to take a foot impression with the thumb impression box phone box impression allows the lab to fabricate three custom diabetic inserts or any type of custom orthotic first seat the patient with a ninety degree angle at the knee patient should sit far enough forward that pressure can be exerted freely above the knee instruct the patient to relax allow use to provide even pressure and not assist you in exerting pressure hold the lateral and medial malleolus in assuring a neutral position of the talus and exert pressure from above the knee press heel deeply into the foam impression box the depth of the phone and chrtien box should be governed by the height of the longitudinal arch this ensures a positive cast do not press the foot down to the bottom of the box as this will distort the tissue maintain the limb at 90 degrees press the instep down into the film impression box with uniform pressure please ensure the impression extends 3/4 of the way throughout the phone this is essential