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Medical Provider Forms

Medical forms are provided for physicians and podiatrists to support insurance coverage for therapeutic footwear and custom orthotics for patients with diabetes and qualifying foot conditions. Proper completion of these documents helps establish medical necessity meet insurance requirements and support timely evaluation fitting and dispensing. Priority Footwear manages eligibility verification documentation and coordination to support compliance and continuity of patient care. 

Download the medical form.

If you have questions about forms or the process, contact:

Priority Footwear
10240 SW Nimbus Ave Ste L1
Portland, OR 97106
1-866-557-3478
info@priorityfootwear.com