YOU MAY BE ELIGIBLE
to receive diabetic shoes as part of your diabetes management plan. Please click on the BUTTON below to print off the required documentation needed per the Medicare Therapeutic Shoe Bill. Below is a list of the required information needed before you are eligible to be fitted for diabetic shoes.
- Statement of Certifying Physician - Signed via MD or DO only
- Prescription signed and dated for Diabetic Shoes and Inserts by - DPM, MD, DO, PA NP or CNS who performed the Foot Exam
- Diabetes Management Exam Note - Signed and dated by MD or DO only within the last 6 months.
Click Here to Download Diabetic Shoe Prescription Form
- This process can be complicated so please call (612) 334-3159 with questions.
- Dahl Medical has a team of shoe fitters ready to make home visits.