Lifts Order Form I am a healthcare provider and have a MojoFeet account. * Yes, I have a MojoPro account No, I don’t have a MojoPro account No, I am a patient MojoPro Information Doctors Name * Clinic Name * Phone Number * Email * Product Order Information Patient Name Shoe Size * 44.555.566.577.588.599.51010.51111.51212.51313.51414.51515.5 Gender * Men’s Women’s Side * Left Right FFL Height (in mm) * Taper Height (in mm) Quantity * Note: Our standard is that lifts 6mm or less are not tapered. Lifts over 6mm are tapered to half of the height of the lift (starting distal to the metatarsal heads). If the resulting taper drop is greater than 5mm we will start the taper more proximally. If you require something other than our standard taper please indicate in this column and we will taper to your measurement. plus1 Add Another Order minus1 Remove Become a Mojo Pro Join our campaign of healthcare providers on a journey to change lives through movement. We are fanatical about feet and their role in human health and performance. We realize that strong, functional feet are literally the foundation for a healthy body and an active life. Learn More Find a Mojo Pro Our lifts and orthotics can be purchased through our Mojo Pros. Find a Mojo Pro Near Me reCAPTCHA Submit If you are human, leave this field blank.
