To order your custom fitted '2.ft Orthotics'

Step I :

Complete 'Client Questionaire' form

Step II :

Choose option A or B

Option A:
Home 'Foot Analysis Kit' only

Option B:
Complete: Home 'Foot Analysis Kit' and Custom '2.ft Orthotics'

Step III :

Prepare your home 'Foot Analysis Kit' and return to us

Singapore Address
545 Orchard Road, #05-06,
Far East Shopping Centre,
Singapore 238882

Step IV :

If you chose
Option A: Forward balance of funds and expect your orthotic within 2 weeks

Option B: Wait 2 weeks for your custom '2.ft Orthotics'

Order Form

* This field is required to be filled up

*Name:

Address:

Postal Code:

Tel(H):

Tel(O):

*Email:

Age:

Sex:

M

F

Weight:

Shoe Size :

     

Hours per day on your feet:

4

6

8

10

12

14

Type of work employed:

  

Walking Shoe:

Do you practice sports?

Yes

No

 

Sports Shoe:

State Foot Related Problem

Did your family Doctor diagnose your problem ?

Yes

No

Other Complaints:

Leg

Knee

Hip

Calf

Back

Explain:

Have you had surgery?:

Yes

No

Foot

Knee

Back

Explain:

*Payment Method:

Credit card

Money order

Tele-transfer

             

Note: For credit card payment, fax us your VISA/MasterCard or American Express number. For 'faxing form' in MS Word or PDF format
* This field is required to be filled up