NLBL Clinical Bundle

NLBL Clinical Bundle Intake

Internal staff use only. Complete all fields below, then choose the correct clinical bundle.

Patient Name

Patient DOB

Assigned Practitioner

Assigned By

Office

Referring Doctor

Select Bamboo Comfort (NLBL Clinical Bundle).

Select ETC+ Performance (NLBL Clinical Bundle).

Please complete all required fields before continuing.

Free Shipping Both Ways

Your impression kit, prepaid return, and finished custom orthotics all ship at no extra cost.

DESIGNED FROM YOUR IMPRESSIONS

Built from impressions of your actual feet—not stock shapes or generic templates.

C.Ped. Designed

Every pair is reviewed and designed by a Certified Pedorthist, with CNC milling used to produce the custom shell consistently.

No Prescription Needed

Take the Fit Assessment, make your impressions at home, and we’ll handle the rest.