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Order Form                   Frequently Asked Questions

A sample order form is shown below to better assist you in preparing your order. A printed copy of this form will arrive with your Foam Impression Kit once your initial order is placed. Please complete that copy of the form and return it with your Kit to CustomLab. To begin your order, call our toll free order number. Our operators are ready to assist you fully. Toll Free Number: 1(866)882-1867

            Custom Made Orthotics Order Form (Sample)

 Customer Information (required to process your order)

Name:
Address:
Telephone:    (           )
Sex:        Male [            ]   Female [             ]
Age:
Weight:
Height:
Shoe Size:
Shoe Type: (Usual type of foot gear worn.)
Primary Activity for Orthotics:
Orthotic Type, Please insert quantity of pairs desired:   [          ] DRESS                [          ] ACTIVE
Amount Due:  USD $
USD Prices + Shipping & Handling
1st Pair: $99.99
Shipping & Handling on 1st Pair Only: $12.95
Additional Pairs with this order: $65.99 each (Details) All major credit cards accepted.
Once we process your order and payment, we'll immediately send you your postage paid Foam Impression Kit. Upon receiving your Impression Kit back at CustomLab, your new pair of custom orthotics will be fabricated to exacting specifications based on your foot impressions.
Instructions for taking precise impressions of your feet are explained on the Foot Casting Instructions page.