Postings and Adjustments Order Form 8-16-24

POSTING & ADJUSTMENTS ORDER FORM

ORDER INFORMATION :
Company Name : Account #: PO #: Contact Name : Phone : Email : TO ORDER Web orthofeet . shoes
Email orders @ orthofeet . com
Phone 800.524.2845 Ship-To Name : Ship-To Address :
Fax 201.767.6748 City : State : Zip : DESCRIPTION UNIT CODE QTY
Heel Lifts 1 / 8 "
12 pairs
HL8
Heel Lifts 1 / 4 "
12 pairs
HL4
Felt Arch Pads - Small
12 pairs
FS
Felt Arch Pads - Medium
12 pairs
FM
Felt Arch Pads - Large
12 pairs
FL
Posting Strip 3 ” - 17 " Long
strip
3P
Posting Strip 4 ” - 17 " Long
strip
4P
Posting Strip 5 ” - 17 " Long
strip
5P
Rear Foot Post 3 °
6 pairs
RF3
Rear Foot Post 4 °
6 pairs
RF4
Rear Foot Post 5 °
6 pairs
RF5
Metatarsal Pads
12 pairs
MP
Email orders @ orthofeet . com | Phone 800.524.2845 | Fax 201.767.6748 335 Chestnut Street , Norwood , NJ 07648