Orthotic Prescription & Referrals

Please include:

  • Personal details
  • Name, date of birth, phone numbers, NHI, ethnicity (if Crown funded), ACC number (if applicable)
  • Primary Diagnosis and Other Diagnoses especially if these have any bearing on the treatment. For example: Foot Ulcer, Type I Diabetes
  • Prescription Goal – what do you hope to achieve?
  • Detailed description of the type of Orthosis required.

The more information you provide, the better we understand what you want!

Orthotic Centre prescription pads are available. Please use them – especially in the public hospitals. However, if you do not have one, the above details on your business letterhead is sufficient