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Prescription form - BioPed 2026

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The document is a prescription form for lower limb health care, detailing various diagnoses related to foot, ankle, and knee conditions. It outlines treatment options including orthotics, footwear, bracing, and compression stockings. Additionally, it provides instructions for appointments and contact information for Canadian Certified Pedorthists across multiple locations.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient’s name and date at the top of the form. Ensure accuracy as this information is crucial for identification.
In the Diagnosis section, select relevant conditions affecting the foot, ankle, or knee. You can check multiple boxes if necessary.
For Treatment options, indicate your preferences for orthotics and insoles by selecting from custom-made options or off-the-shelf products.
Fill in any additional instructions or specific needs in the Further Instructions section to guide treatment.
Finally, ensure that the referring professional signs and stamps the form at the bottom before submission.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Do prescription orthotics work?

Clinical research studies have shown that podiatrist-prescribed foot orthotics decrease foot pain and improve function. Orthotics typically cost more than shoe inserts purchased in a retail store, but the additional cost is usually well worth it.

Do you need a prescription for custom orthotics?

Orthotics refers to custom-made shoe inserts prescribed by a licensed doctor of podiatric medicine, an osteopathic doctor, or a medical doctor after a medical examination and diagnosis. Orthotics are designed to accommodate or correct an abnormal or irregular walking pattern.

What is the difference between orthotics and custom orthotics?

While OTC orthotics are pre-made and designed to fit a wide range of foot types, custom orthotics are uniquely tailored to match the exact contours of your feet. Dr.

How much should custom orthotics cost?

There are many types of custom orthotics, and they can cost anywhere from $300 to $800. Semi-custom orthotics cost between $60 and $300, and basic off-the-shelf inserts are available for as little as $10 to $20. Some health insurance plans wont pay for custom-made orthotics.

What does BioPed do?

Since 1981 BioPed Footcare Orthotics has proudly helped more than 1 million Canadians. We provide custom orthotic solutions, custom compression solutions, fitted bracing solutions, fitted and custom footwear, and medical footcare solutions, including surgical and non-surgical solutions.

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