WebRecord the leg measurements on the Custom Seamed-Lower Extremities Order Form. 15 For leg circumferences that are greater than the length of the tape straps, add a JOBST … WebFoot length for prosthetics is measured in centimeters, an English standard. Adult feet measure anywhere from 22 to 30cm. In order to properly measure for the shoe, take the …

Printable Forms for Prosthetic Fabrication

WebLower extremity limb measurement Patient to be supine, standing or sitting with foot flexed to 90 degrees measure: - Circumference starting at heel, mid calf, knee, along the leg until 2 cm below the popliteal fossa. If swelling exists above the knee, continue measurements to 2 cm below the gluteal crease LYMPHEDEMA GRADING SCALE WebLymphedema Forms – Measuring and Prescription How to order from SunMED SunMED Lymphedema Supplies Order Form Place an Insurance Order with SunMED Barton Carey Arm and Hand Face Mask and Chin Strap Lower Extremity New Order Cover Sheet Vest, Body, Brief, Body Suit BiaCare Arm Assist Chip Sleeve Arm Chip Sleeve Below Knee Chip … dischem clearwater mall

Order Forms - L&R USA

WebTurn on the Wizard mode on the top toolbar to obtain more recommendations. Fill in every fillable field. Make sure the info you add to the Prosthetic Measurement Form is updated and accurate. Indicate the date to the document with the Date function. Click on the Sign button and make a signature. WebMeasurement Forms Upper Extremity Measurement Form Shoulder Measurement Form Lower Extremity Measurement Form Optional Handplate Measurement Form for JAS … WebLymphedema Evaluation Form Word Document PDF Fillable Lymphedema Evaluation Form Word Document Genital Self-assessment Questionnaire (male) Word Document PDF … dischem clinic bookings