Before Your Shoe/Foot Orthotics Visit

Forms and Insurance Requirements

We understand that the insurance process can be complicated, and we are here to help. This page explains the paperwork requirements for diabetic shoes and inserts. One thing that is always required is a prescription. The prescription must come from your doctor, we cannot write one for you. If you do not already have a prescription, our office can provide you with the details you will need to bring to your physician to obtain a prescription. If you have any questions, please call us at 413-785-4047 or 860-904-2419.

Patients should also contact our office to determine whether a medical release form should be needed.

Forms and required medical documentation for your first visit:

1. Prescription dated within 6 months of being dispensed new shoes and/or inserts.
2. Notes from last diabetic management checkup within the last 6 months with PCP or endocrinologist. This checkup must be had with an MD or DO. NP and PA notes do note qualify per medicare rules.
3. Foot Evaluation done within 6 months of being dispensed new shoes and/or inserts.
4. We will also need additional documentation from the same MD or DO which we will send after your evaluation appointment

Due to constantly changing medical insurance plan requirements, it is advisable to contact our office for the most up-to-date information.