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Prescription Form

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Prescription Form
FORM

Orthotic Prescription Form — Submit Your Order

Ready to order custom orthotics with MM Podiatry?

To order, you’ll need:

  • Your patient’s diagnosis, key clinical findings, footwear, and primary goals.
  • Your chosen orthotic prescription route — by pathology, by device type, or fully bespoke.
  • Your foam impression or slipper cast ready to post, or your scan file ready to upload.

Complete the custom orthotic prescription form below. We’ll manufacture your device and dispatch within ten working days

After you submit, we will confirm receipt and check for any missing information. If anything needs clarifying, a clinician will contact you before manufacture begins. Standard turnaround is ten working days from approved order to dispatch.

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Not Sure About the Prescription?

Send us a brief case summary before submitting — we will review the design with you first. You can also run a case past us before deciding whether to prescribe at all.

Note: this prescription form is for registered clinicians only: podiatrists, MSK physiotherapists, and GPs with extended MSK roles. If you are a patient looking for orthotics, please speak to your clinician. This form integrates with Cliniko, Jane, SimplePractice, and Power Diary.

Book a 30-minute call before you order
TESTIMONIAL

What Our Partners Say

As a busy private podiatry practice, bespoke foot orthoses sit at the core of our MSK service, so we’re very selective about who we work with. Since moving to this MM Podiatry, the consistency and quality of the 3D‑printed orthotics have been excellent, reliably reducing pathological tissue loading and giving us the stable mechanical foundation we need for rehab.

The integrated RehabHub 3D platform is a genuine value‑add for our patients. It allows us to progress tissue loading in a structured, evidence‑informed way and gives patients clear, accessible plans that complement their orthoses instead of just a generic exercise sheet. We also use it for prehab and minor niggles between appointments, which has noticeably improved engagement and adherence.

Together, the orthotics and digital rehab pathways have made our MSK care feel more joined‑up and professional. We spend less time on admin and workarounds and more time delivering a complete journey from overload and pain to restored function and confidence.

Marie Young, Senior Podiatrist & Practice Owner
Allerton Road Foot Clinic, Liverpool

As a relatively new podiatry practice, I’ll admit I lacked confidence when it came to prescribing bespoke orthoses. I knew some of my patients needed more than off‑the‑shelf devices, but the sheer number of design choices, variables and suppliers made me nervous about getting it wrong. Partnering with MM Podiatry has completely changed that.

The prescription process is clear and guided, and the support behind it has been invaluable. I feel like I have an expert ‘in my corner’ helping translate my clinical findings into high‑quality, 3D‑printed orthotics that actually do what I need them to do.  My confidence has grown and so has my willingness to take on more complex MSK patients.

Having RehabHub 3D alongside the orthoses has been a big bonus. It gives me ready‑made, professional rehab prescriptions that I can quickly tailor to each patient, instead of piecing exercises together from scratch. Patients see it as a premium, joined‑up service rather than just “getting some insoles”, and that’s helped me grow the MSK side of the business much faster than I expected.

Working with MM Podiatry has allowed me to offer a level of orthotic and rehab care that feels more like an established MSK clinic than a start‑up, and it’s given me the confidence to build my reputation in this area.

Simon Barnes, Podiatrist & Owner
Newton Podiatry