HOME FEATURED BRANDS 13 WEEK GROWTH FREQUENT BUYER PROGRAM PEDORTHICS REPAIRS ABOUT US Pedorthics These forms are required if you plan on going through insurance on our Pedorthic side: Prior to your appointment print and complete: a) Patient Responsibilities b) Patient Facesheet c) HIPAA Privacy Receipt Acknowledgement To verify coverage with your insurance for custom orthotics please print, complete and bring to your appointment: Insurance Verification Form for Patients Medicare Diabetic Shoe/Insert Coverage (print forms and follow steps below) This form explains qualifying conditions and step-by-step instructions (diabetes only does not qualify, you must have a severe foot condition) a) Patient Responsibilities Print and take these 2 forms with you to your next appointment with the M.D. or D.O. treating your Diabetes b) What Medicare Requires from the Certifying MD/DO c) Statement of Certifying Physician for Therapeutic Footwear Fred Toenges Footwear and Pedorthics 3910 West Jefferson Blvd, Fort Wayne, IN 46804 260.484.4742 | customerservice@toengesshoes.com Copyright © 2021 All rights reserved.

HOME FEATURED BRANDS 13 WEEK GROWTH FREQUENT BUYER PROGRAM PEDORTHICS REPAIRS ABOUT US 13 Week Growth 13 Week Growth Allowance We offer a free program called our 13-week growth guarantee. On average a child can grow a half size every three months, which means keeping them in a pair of properly fitting shoes can be challenging. We offer the 13-week growth guarantee as a way to help minimize the cost of putting your child in new shoes every three months. Here is how the program works, if your child outgrows their shoes within the 13 weeks, we pro-rate the time left and apply it to the new shoe. An example would be: you buy a shoe for $50.00, and the child outgrows the shoe in 10 weeks. We divide the $50.00 by 13 and get $3.85, and then you take that number times 3 (for each week left in the 13 weeks), which gives you $11.55. We would then take $11.55 off the purchase price of a new shoe *some exclusions apply, see store for details*. We encourage parents to come in and have their children’s feet checked regularly. Fred Toenges Footwear and Pedorthics 3910 West Jefferson Blvd, Fort Wayne, IN 46804 260.484.4742 | customerservice@toengesshoes.com Copyright © 2021 All rights reserved.