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Healthy Legs
Certified Support Hose Fitting Center
Toll Free 888 495-0105
http://healthylegs.com

Physician/Health Care Referral Form

Healthy Legs® is an Authorized Dealer and Fitting Center.

Make it easy for your patients to receive the products they need, in a timely manner,
with professional advice from our "Certified Fitters."

We can also send you copies of this form
by regular mail.

This form is in PDF format. In order to open, view, and print them, you must have Adobe Acrobat Reader installed on your computer.


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Healthy Legs® Jobst. Sigvaris, Medi, and Juzo Retail Fitting Center and support hose super center is located in Portland, Oregon. Our Medi, Sigvaris, and Juzo Certified Fitters are available by phone or e-mail to answer your questions and help you select the correct support hose, support socks, and support stockings. We carry all major brands including Jobst Support Hose and Support Socks, Mediven and Medi USA Support Hose, Sigvaris Support Hose, and Juzo Support Hose. Healthy Legs® has the largest online selection of diabetic socks and medical socks for people with sensitive feet due to diabetes, arthritis, and foot pain.

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