If any of the following forms fail to download, please send an e-mail request to: james@kevinhearon.com
Foot Examination Form

For doctors that have completed the Council on Extremity Adjusting's (CEA) course on Foot, Gait and Orthotics module. This form will enable CCEP's to correctly examine the foot for making or prescribing foot orthoses.
(PDF Format, requires Adobe reader)

>>Download Adobe PDF Reader here<<
Letter of Medical Necessity

Send this letter in with your claim forms for orthotics. Be sure to format to accommodate your company's logo and address.
(MS Word 2003 format)
Chiropractic Exam Form

Designed for doctors trained in Extremities Adjusting, this form is perfect for graduates of the CCEP program.
(PDF format)

Patient Progress Report

Keep all of your patient notes handy for reference with this patient progress report.


Dr. Hearon's Orthotics
Examination Station

A very handy piece of furniture for examining the feet and storing orthotics. This station will enable the skilled CCEP to quickly and efficiently make custom orthotics for their patients on the spot!

Special Order Form for CCEP's

Pacific Medical is offering a discount to CCEPs on the DonJoy® Protective Knee Guard (PKG). Click and print this order form.

Knee Flow Chart of Conservative Care

Avoid repetitive orthopedic testing/challenging of ligaments of the knee during the healing process until near the end of the healing period. Allow the new filaments of the ligaments to reattach with out you disrupting them constantly.