Questionnaire Form Login Username or email address * Password * Remember me Log in Lost your password? Register First Name * Last Name * Username * Email address * A link to set a new password will be sent to your email address. Subscribe to our newsletterYour personal data will be used to support your experience throughout this website, to manage access to your account, and for other purposes described in our privacy policy. Register "*" indicates required fields 112233445566778899101011111212131314141515 HiddenName First Last HiddenCustom Orthotics Order Id HiddenBox Order Reference HiddenCustomer User Id Do you need orthotics for an adult or for a child? Adult Child Do you need orthotics for an adult or for a child?* Do you have foot pain? Pain No Pain Next Do you have foot pain?* Where is your pain? Arch pain L R Heel pain L R Forefoot pain L R Ankle pain L R Achilles pain L R Everywhere L R Knee L R Hip L R Lower Back L R Where is your pain?* Please select the main reasons you want custom orthotics for? Correct flat feet Increase Support Improve alignment Reduce risks of injury Improve sporting performances Update current orthotics 2nd pair for other shoes I was recommended to get them Please select the main reasons you want custom orthotics for?* Rate your level of pain on a scale of 0 (no pain) to 10 (can’t walk anymore) (0) (10) Level of Pain : 5 Level of pain* Have you been diagnosed with a foot condition? Next HiddenHave you been diagnosed with a foot condition?NoYesTell us more* Be yourself! Do you wear men or women shoes? (for sizing purposes) Men Women Be yourself! Do you wear men or women shoes? (for sizing purposes)* Who are you buying for? (for sizing purposes) Boy Girl Who are you buying for? (for sizing purposes)* What shoe will you be wearing your custom orthotics in? Dress Sport/Running Everyday Shoe Tradie boot What shoe will you be wearing your custom orthotics in?* What shoe will you be wearing your custom orthotics in? Dress Sport/Running Everyday Shoe School Shoes What shoe will you be wearing your custom orthotics in?* Dress Ballet Flats Low Heels Dress Boots Derby Dress(Women)* Dress Riding Boots Boat Shoes Dress Boots Derby Dress(Men)* What sport do you play? Running Fitness walking/hiking Cricket Tennis Weights Circuit/HIIT Golf Hockey Soccer Rugby AFL Cycling Basketball Netball Other Sport/Running* Everyday shoes Lifestyle Canvas Sneakers Casual Next Everyday shoes* Do your shoes have removable innersoles? Most of them are, but please check. I don’t know Do your shoes have removable innersoles? Most of them are, but please check.* What size shoe size do you wear? (US 1 to US 14)11.522.533.544.555.566.577.588.599.51010.51111.51212.51313.514How much do you weigh?Under 5050-6565-7575-8585-9595-105105+This is to ensure the right balance of support and cushioning Your Answers Do you have foot pain? Change Custom Orthotics selected Reasons Change Any Medical Condition? Change Men or Women Shoes? Change Your type of shoes? Change Removable Insoles Change What is your size? Change What is your weight? Change You’re only one step away… This is what happens next: Step 1 Place your order Fill in your details and take a step towards a pain free life Step 2 Make your mark Receive your Impression Kit in 2-3 days time, make your imprint and send it back to us- no charge. Step 3 Receive your custom orthotics We will 3D scan your imprint; send your orthotic script and you will receive your custom orthotics in just 10 business days. You're almost there!*Get expert podiatrist insights and personalised recommendations—share your email to receive your results and a follow-up from our team! Enter Email Confirm Email Follow on Instagram This error message is only visible to WordPress admins There has been a problem with your Instagram Feed. $389.00Add to cart