Piedmont Orthotic Laboratory, Inc.


We at POL Inc. are proud to offer on a wide range of the finest foot care devices to fit your patients' needs.

For more information on pricing contact us directly. Be sure to ask about our volume discount and promotional offers!

Order Forms for Professionals

You will need Adobe Acrobat Reader to open the forms below.
(To save forms to your computer for future use: right click on link, select "save target as..." option, and save in a local directory)

Prescription Forms

Custom Orthotic order form. (polrx.pdf)

NAOT Sandal Insole order form. (naotrx.pdf)

Ultimate Pre-Molded Orthotic order form. (ultimate.pdf)

Credit Application for Professionals

POL Credit Application for healthcare professionals.(credapp.pdf)

USPO Business Reply Labels

USPO Business Reply Labels: for use when sending casts and foams via the United States Post Office. 

Copyright 2003 Piedmont Orthotic Laboratory, Inc.