Patient Registration and Intake Documents



Would you prefer to see an Orthotist on the weekend? We strive to accommodate the patient’s needs and offer Saturday appointments by request only.

Would an evening work better for you, or an early morning appointment? We know you can’t always be available on a weekday during normal business hours. We are flexible! Please contact us to request an appointment outside of our normal business hours.

Is it a struggle to get transportation? We can schedule a home or facility visit for you – use our contact form or give us a call to arrange.





We work closely with the referring doctor and/or therapist to develop a comprehensive plan of treatment and manufacture/dispense progressive orthotic and prosthetic solutions of the highest quality. Our products are available by prescription only:


Orthotics – Custom and off-the-shelf orthopedic bracing

Compression – Full line of lymphedema, vascular and burn garments

Diabetic footwear – Custom and Extra Depth shoes with multi-density diabetic inserts

Shoe inserts – Custom made for superior functional support

Mastectomy – Full service of mastectomy prosthetics and bras

Cranial Remolding





  • Products of exceptional quality
  • Customized plan of care to meet patient’s needs
  • Consistently exceeds expectations
  • Service with emphasis on compassion
  • Competitively priced




We are in network with most insurance companies and will happily file our product claims through your insurance provider.





PATIENTS: To get an appointment, you need a referral from a doctor. Let your physician know that you would like to see Tierney Orthotics and have their office email or fax the prescription and your demographics sheet. We will contact you for an appointment and schedule it when it is convenient for you.


DOCTORS: To refer a Diabetic patient, please email prescription and demographic sheet to ““. Referrals can also be faxed to Cindy’s attention at 866-403-2483. We will contact the patient to set up the appointment.Please do not hesitate to call us directly if you have any questions. We look forward to working with you.

Since 2014, Tierney Orthotics and Prosthetics has become the Winston-Salem, North Carolina area’s preferred source for orthotics, prosthetics, diabetic footwear, mastectomy prosthetics, and shoe inserts.