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Welcome back!  We are glad you have decided to continue improving your foot health with orthotics.  Our new Online Order Form will allow you to make your shoe selections from the comfort of your own home.  Remember to make a first AND second shoe choice in the event that your first choice is not available. If your foot health has changed since your last order, we recommend having a new orthotic assessment to ensure that your orthotics will be giving you the best support possible.

Need a refresher on the orthotic process before filling in your order form? Click here!

Re-Order Orthotic Shoes Online

*Last Name:

Former Last Name (if applicable):

*First Name:

*Address:

*Town/City:

*Province:

*Postal Code:

*Home Telephone:

Business Telephone:

Cell Phone:

*E-mail Address:

*Date of Birth:

Occupation:

*Current School:

Sunlife Member Name:

Sunlife Contract Number:

*Sunlife Member ID #:

*Is your spouse a member of

another benefit plan?      

Yes

Spouse’s Last Name:

Spouse’s First Name:

Spouse’s Date of Birth:

Type of Coverage:  Single

Family

*Shoe Choice 1:

Supplier or Website Link:

Style:

Colour:

Size:

Width:

*Shoe Choice 2:

Supplier or Website Link:

Style:

Colour:

Size:

Width:

If yes, please provide details below:
No
Information must be filled out to process your request without delay
(eg. 10 digits - 905-878-2333 - no spaces)
How to find the web link (PDF)
How to find the web link (PDF)
(eg. 10 digits - 905-878-2333 - no spaces)
(eg. 10 digits - 905-878-2333 - no spaces)
Click here here to see the website options
Click here here to see the website options
Patient History
* Details must be inserted
www.newbalancetoronto.com
www.timberland.com
www.oolab.com
www.orthoticenergy.com
www.foottools.ca

Local Partners

Walking on a Cloud - Milton

1095 Maple Ave. L9T 0A5

(next to Boston Pizza)

www.walkingonacloud.com

 

Running Free - Milton

515 Main St. E. L9T 3J2

(across street from Winners)

www.runningfree.ca

 

Ecco Heartland Outlet

5875 Rodeo Drive

Mississauga L5R4C1

www.eccocanada.com

 

Golf Town

1215 Maple Ave

Milton L9T 0A5

www.golftown.com

Websites
www.drewshoe.com