Payment Information

Thank you for choosing SOLO! Please complete and submit this form so we can process payment for your orthotics.

We will email you at the address you provide below to confirm the amount we will charge.

Your credit card information is not stored on our site. It is submitted to our accounting department for processing and then destroyed.

The person we are making the order for.
Receipt will be sent to this address when the order ships.

Billing Address(Required)

This field is for validation purposes and should be left unchanged.