Prescription Forms & Insurance Documents

Seliga Shoes has specialized forms to help streamline our pedorthic process and improve care to our pedorthic clients.

If you are interested in Pedorthic services to be billed to private insurance, you will need the:

• Lower Extremity Rx AND
• Letter of Medical Necessity

If you are interested in Pedorthic services as part of the Therapeutic Shoes for Diabetics, you will need the:

• Diabetic Rx AND
• Statement of Certifying Physician

To contact Medicare direct for additional information Medicare

Additional Sources of Information

• American College of Foot and Ankle Surgeons: (800-421-2237)
  
• American Orthopedic Foot and Ankle Society: (206-223-1120)
  
• American Physical Therapy Association: (800-999-2782)
  
• American Podiatric Medical Association: (800-275-2762)
  
• Pedorthic Footwear Association: (800-673-8447)