Please fill in a valid value for all required fields
Please ensure all values are in a proper format.
Are you sure you want to leave this form and resume later?
Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.
Save and Resume Later
Save and get link
You must upload one of the following file types for the selected field:
There was an error displaying the form. Please copy and paste the embed code again.
Apply Discount
You saved
with code
Submit Form
Submitting
Validating
There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.
Please check the field:
Fields
Practitioner Name
*
First Name
*
Last Name
*
Phone Number
*
*Only used for questions regarding exam
*
Cell Phone
Office Phone
Home Phone
Practitioner Credentials
*
Ex: CO, CP, CPO, Cped, etc.
ABC Certification #
*Numeric Value. Requested so ABC can apply CEUs. Not submitted to states with licensure.
BOC Certification #
*Numeric Value. Requested so BOC can apply CEUs. Not submitted to states with licensure.
Email
*
Confirm Email
*
*Will only be used to send Certificate of Completion or Custom updates to you.
Facility Name
*
Facility Address
*
Address Line 1
Address Line 2
City
State/Province
ZIP / Postal
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia, Plurinational State of
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-bissau
Guyana
Haiti
Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People\'s Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People\'s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Republic of Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania, United Republic of
Thailand
Timor-leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Click Video Below to View Custom AFO Course
Begin Exam
1. The custom ToeOFF® or BlueROCKER® was NOT designed as an answer for patients who
*
Regularly delaminate standard ToeOFF® or BlueROCKER®
Have deformity or unusual leg shape
Are in need of increased AP control
Have extremely limited or excessive leg shape
2. It is recommended to assess the patient in a
*
Solid ankle molded AFO
PLS AFO
Standard ToeOFF® or BlueROCKER®
Short articulated AFO
3. For a custom ToeOFF® or BlueROCKER®, it is recommended to capture the model using
*
Fiberglass cast
Scan
Measurement
All of the above
4. A significant aspect in achieving success with a custom ToeOFF® or BlueROCKER® is
*
Knee center measurement
Proper shoe size
Matching the heel rise of the ToeOFF® or BlueROCKER® to a rocker soled shoe
Having a prescription from an MD
5. When sending a cast for a custom ToeOFF® or BlueROCKER®, the cast must be a
*
Plaster cast with posterior-medial opening, no plumb lines
Fiberglass cast with anterior-lateral opening, no plumb lines
Plaster cast with anterior opening, anterior and lateral plumb lines
Fiberglass cast, posterior-medial opening, anterior and lateral plumb lines
6. To minimize trunk sway, one could consider a custom ToeOFF® or BlueROCKER® with
*
Increased M-L stiffness
A change in the heel rise
Extra space to add a ComfortKIT
Increased height of the pre-tibial shell
7. It is no longer necessary to use a foot orthotic shell to control the biomechanics of the foot with a custom ToeOFF® or BlueROCKER®
*
True
False
8. A patient presents with 15°of genu-valgum. A foot orthotic provides little or no correction. The best way to accurately represent this angle is to
*
Take a tracing of the patient’s unaffected limb
Draw plumb lines on the cast with patient standing
Draw plumb lines on the cast with patient casted in neutral
Write down your measurement of the angle on the custom form
9. A patient who is of average size and shape but has delaminated two standard ToeOFF® or BlueROCKERs® is a candidate for
*
Custom ToeOFF® or BlueROCKER®
Properly customized standard ToeOFF® or BlueROCKER®
A solid AFO
Patient of the month
10. On a trial fitting, both the distal and proximal wings of a ToeOFF® or BlueROCKER® are digging into the leg of a 300lb patient. The best course of action is to
*
Fit the patient with a Solid AFO
Heat the wings and spread them out
Increase the dorsi-flexion angle
Cast the patient for a custom ToeOFF® or BlueROCKER®
11. With 5/8” (15mm) heel and ¼” (5mm) ball height measurements in the patient’s shoes, the heel height you should request on the custom form is
*
3/8” (10mm)
½” (12.5mm)
¼” (5mm)
¾” (20mm)
12. Which of the following are critical to achieving success in fitting a custom ToeOFF® or BlueROCKER® as well as a standard ToeOFF® or BlueROCKER®
*
Foot orthotic shell
Rocker soled shoe
Patient education
All of the above
13. The dynamic properties of Allard carbon composite AFOs are
*
All considered equal
Just like PLS AFOs
Different, depending on the number of layers and the orientation of the fibers in the lay-up
Less dynamic than plastic AFOs
14. To establish a baseline used to determine the dynamic qualities of the custom ToeOFF® or BlueROCKER®, you should
*
Evaluate the patient with a ToeOFF® or BlueROCKER®
Simply send the cast to Allard to have them decide for you
Use a hinged AFO and see if that works well for the patient
Figure out what the patient’s needs are by watching him/her walk from the parking lot into your office
15. A custom ToeOFF® or BlueROCKER® candidate presents with mild crouch gait. One way to accommodate for this is to
*
Increase the M-L stiffness, and make sure that the anterior plumb line shows the proper angle
Soften the toe end of the footplate to enhance roll-over
Increase the A-P stiffness by up to two times of the baseline (standard ToeOFF® or BlueROCKER®)
Increase the heel height
16. A post-polio patient is a candidate for ToeOFF® or BlueROCKER®, but due to extreme calf atrophy the fit of the standard ToeOFF® is less than optimal. You should
*
Proceed with a custom ToeOFF® or BlueROCKER®
Tell the patient to stick with what she has been wearing
Try to convince the patient to use a different product
Pad the standard ToeOFF® or BlueROCKER® to accommodate for the decrease in muscularity
17. Because of the flexible nature of carbon composite AFOs, it is not necessary to make sure the heel rise is accurately matched to the shoe
*
True
False
18. A CMT patient presents with moderate equino-varus deformity. You should
*
Add a medial T-strap on the ToeOFF® or BlueROCKER®
Grind down the medial plantar surface of the foot orthotic to encourage eversion
Fit the patient with a custom ToeOFF® or BlueROCKER® to accommodate the need for more room on the lateral side
Do choice B, then choice C if necessary
19. When completing the measurement form for the custom ToeOFF® or BlueROCKER® it is necessary to
*
Fill out all of the boxes on all the pages
Take a photo of the leg from 6’ away on the same level as the leg
Place a vertical piece of tape exactly 4” in height on the calf
All of the above
20. When seeking to relieve pressure off the tibial crest the proper procedure is to
*
Mark the relief on the cast and fill in the appropriate box on the forms
Instruct your purchasing manager to make it happen
Mark the patient’s leg once the cast has been removed
Only fill out the forms
21. What is the tallest a custom ToeOFF® or BlueROCKER® can be made?
*
17 ¾” (45cm)
22” (56cm)
20” (51cm)
16” (41cm)
22. Which of the following options would make you order a Select Custom AFO vs a ToeOFF® Custom?
*
20mm heel height (3/4”)
Increasing the ML Stiffness
Off-Load for 5th MTP
310mm footplate length (12¼”)
23. What modification would have an extra charge?
*
Custom footplate length
Increasing the AP Stiffness
Relief of the tibia
Increasing the width of the footplate
24. What is the warranty for a SELECT Custom AFO?
*
Two replacements within a year of the original fit date
One replacement within six months of the original fit date
Three replacements within one year of the original fit date
One replacement within one year of the original fit date, if no changes to strut location or heel height
25. Which of the following needs to be captured when sending your own scan to place your order?
*
Foot in neutral position with arch visible
If wearing corrective orthotic, scan with orthotic in position
Foot and knee in 90° of flexion or desired heel height
All of the above
26. When submitting a fiberglass cast, how does Allard USA use a cast to create a mold for a Custom AFO?
*
Pour plaster into the cast
Scan the outside of the cast and send that image to Sweden where there is a mold cut out by a CNC machine
Use the cast as a mold
None of the above
27. Ordering by measurements would be a valid choice in which of the following?
*
Patient with short leg and long foot
Patient that needs relief of the 5th MTP
Relief of a bony tibia
Off load for a high instep
28. How soon should the warranty be registered?
*
Never
Within a year
Within six months
Within ten days
29. A Measurement Form is required to be submitted along with a cast
*
True
False
Test Score
Save and Resume Later
Previous
←
Next
→
Progress
Powered by Formstack
Create your own form
›
Enter your save and resume password
Cancel
Confirm