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Apis custom shoe order form 2026

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Click ‘Get Form’ to open the apis custom shoe order form in the editor.
Begin by filling in the P.O. No., Bill To, and shipping details including Address, City, State, and Zip. Ensure all contact information is accurate for seamless communication.
In the Patient Name section, provide the patient's name along with their sex, weight, and height. This information is crucial for customizing the shoes.
Indicate whether you are ordering with shoes by selecting 'Yes' or 'No'. If yes, specify the Shoe Style and Color from the catalog provided.
For the Custom Orthotic Order Section, mark any diagnoses that apply and indicate problem areas on the foot using O for ulcers and X for calluses/pain points.
Fill in specifications for orthotics including material choices and base density. Be sure to specify quantities as needed.
Complete the Shoe Modification Order Section by detailing any modifications required such as rocker types or flares. Provide measurements where necessary.

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