Instructions

Thank you for trusting your compliance needs to R.J. Hedges & Associates!  By completing this questionnaire, we are able to extract all the information needed to complete your customized Diabetic Shoe Program.
 
We know you are busy and may not be able to complete this questionnaire in one sitting.  By using the Stop and Return feature, you will be able to save your work and come back as many times as needed.  Please be sure to complete all required fields accurately.  You are able to amend any answer up until you submit the form.
 
When completed, you will be prompted to pay $500 via PayPal.  Once payment is confirmed, one of our Project Managers will customize your files and grant you access to the Compliance PortalĀ®. If you have any questions, you may always send questions to sales@rjhedges.com or call 724-357-8380

Save & Return

Save your progress and complete this form later. (optional)