For Therapists

To get a brace, please complete an order request form. The online form is secure and encrypted. Order request forms may also be printed and faxed. Please mention brace referral and pertinent details in your most recent therapy note. We do the rest.

For Prescribers

If you would like to use our prescription form (checkbox format), please print, complete, and fax directly to us. We do the rest. 

For Self-Referral 

If you are interested in a brace for yourself, please complete and return the printable form OR complete the online form. We will contact you for a phone (or if necessary, in-home) consultation before contacting your medical provider.