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Unfortunately more than 2/3 of the population suffers with problem feet .

 

 

At Infinite Health Custom Shoe Lab……. we can help.

 

Infinite Health Custom Shoes

2914 Sheppard Ave. East, Suite 206, Scarborough, Ont. M1T 3J4

Phone: (416) 499- 5656 Fax: (416) 499-5797

                                                                Audrey Traitses R.N.
                                                                Dr. George I. Traitses
                                                     BSc (Hon), DC, MSc, CHN, CCRD, CNM, ACRB1

Store Referral Form

Date:____________________________

Clients Name:________________________________________________________________

Reason for Referral:___________________________________________________________

_____________________________________________________________________________

 

Custom-Made Orthopedic Footwear

Modifications: (if known)

Leg Length Discrepancy R ____________ L ____________

Sach Heel

Medial Flare ______________ Lateral Flare ______________

Rocker Sole

Other__________________________________________________________________

 

Store Name:___________________________________________________________________

Address:______________________________________________________________________

 

Phone Number:________________________________________________________________

Information Request Form

Select the items that apply, and then let us know how to contact you.

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Last modified: December 12, 2000