_BiaCare_Catalog | Page 31

P: 866.931.0876 F: 866.931.0052 - BELOW KNEE Measure & Order Form Sales@BiaCare.com PO#: Date: Company: Phone: Contact Name: Patient: Sex: Age: Ht: Wt: Bill-To Name & Address: Ship-To Name & Address: MEASURING INSTRUCTION OPTIONS WEB: Scan QR code CATALOG: Page 68 for standard size EMAIL: Sales@BiaCare.com OR visit BiaCare.com Below Knee measuring instructions. PRODUCT INFORMATION LEFT LEG RIGHT LEG ACCESSORIES (additional cost): Size: Size: Cotton Socks (extra pair) Qty: Length: Length: Silver Socks (pair) Qty: Item #: Item #: Strap Extenders Qty: Foot Size: Foot Size: SIZING CHART & ITEM NUMBERS Bottom of Patella C1 C B A COMPREFLEX - BK X - LARGE XX - LARGE 54 - 64 46 - 56 SMALL 29 - 39 MEDIUM 34 - 44 LARGE 40 - 50 29 - 39 34 - 44 40 - 50 46 - 56 54 - 64 24 - 34 29 - 39 34 - 44 39 - 49 44 - 55 16 - 26 21 - 30 26 - 36 31 - 41 36 - 46 REG 1401 - BKR 1402 - BKR 1403 - BKR 1404 - BKR 1405 - BKR LENGTH (CM) REG: 30 - 36 TALL: 36 - 42 TALL 1401 - BKT 1402 - BKT & SMALL REGULAR I 28 - 36 J 22 - 26 K 14 - 18 BiaCare.com • P: 866.931.0876 • 1403 - BKT 1404 - BKT 1405 - BKT COMPREBOOT SIZING LONG 28 - 36 MED/LARGE REGULAR LONG 39 max 39 max XL/XXL REGULAR LONG 44 max 44 max 22 - 26 30 max 30 max 33 max 33 max 19 - 23 18 - 20 20 - 22 F: 866.931.0052 23 - 25 25 - 27 22