Loading page…
Patient Resources
Foot Leveler Template
View the five-page Foot Levelers sample document right here. Choose a page below and use the zoom controls for a closer look—no download is needed.
100%
Page 1: Foot Scan Summary
When zoomed in, scroll sideways to see the rest of the page.
Loading document page…
Read text from page 1
Text extracted from the original PDF. Refer to the page image for its diagrams, measurements, and layout.
Whole Body Summary
Results
Optimal 0-34
Patient:
Pronation Stability Index
106
Date:
Arch Height Difference
5.70
<=1
Exam Date:
Left to Right Balance
1.8
<1%
Examiner:
Orthotic Recommendation
Vital
Moss Chiropractic & Wellness
18209 Hillcrest Avenue Olney, MD 20832 301-570-9000
Date of Birth:
Optimal feet
Your scan
Pronation Stability Index™(PSI) 0-34
35-84
85-124
125+
Optimal
Mild
Moderate
Severe
Arch Height Difference
106
PSI
106
Recommendation Custom Orthotics
Foot Levelers is the only custom orthotic that restores healthy function in all three arches
Left
Right
49.1
50.9