Shapecrunch USA Form

1
Name
First Name
Last Name
2
Phone Number
Country Code
Phone Number
3
Which size paper you have ?
A4 Size
US International Size
4
Picture from TopOn Standard Size sheet
5
Image from Top (L) Take an A4 Size paper. Place it on ground again the wall. Make sure its touching the wall. Place your foot on paper same way touching the wall. This will give us exact foot length and foot width.
6
Image from Top (R)Take an A4 Size paper. Place it on ground again the wall. Make sure its touching the wall. Place your foot on paper same way touching the wall. This will give us exact foot length and foot width.
7
Left foot - Arch Side PicturePlease stretch your foot
8
Left Side ArchStand on ground, put one feet ahead and stretch your toes up and click photo from arch side(Gap side)
9
Left foot - Bottom View
10
Left Bottom view Sit on a char, put your phone parallel to feet and click photo
11
Right Foot Arch Side PicturePlease stretch your foot
12
Right Side Arch (With a Friend)Stand on ground, put one feet ahead and stretch your toes up and click photo from arch side(Gap side)
13
Right Side Arch (By Yourself)Stand on ground, put one feet ahead and stretch your toes up and click photo from arch side(Gap side)
14
Right foot - Clicking Bottom Image
15
Right Bottom view Sit on a char, put your phone parallel to feet and click photo
16
How to click back photoYou can put your phone against wall with timer and upload the image NOTE: KEEP PHONE ALMOST GROUND LEVEL
17
Back of FootStand on ground. Fold your pants till knee. Keep your foot shoulder distance apart, and take picture from back.
18
Do you want this report in your mail also
YESNO
19
Email
example@example.com
20
Do you have any foot pain(LEFT FOOT)
21
Do you have any foot pain(RIGHT FOOT)
22
Gender
Male
Female
Dont want to disclose
23
Whats your age ?
24
City
25
Enter your foot lengthEnter shoe size if you don't know your foot length
4 US
5 US
6 US
7 US
8 US
9 US
10 US
11 US
12 US
13 US
14 US
26
Describe your problemHave you been diagnosed with a specific problem by doctor. Describe your injury history if any
27
Enter details for BMI calculation
28
Upload your Gait videoMake a video of how you walk from back and front
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
29
Unique ID
Should be Empty:

Save your progress

Save your progress

Your form submission has been saved as a draft.

Save your progress

Your form submission has been saved as a draft.