_BiaCare_Catalog | Page 49

P: 866.931.0876
F: 866.931.0052

®

[e-mail]

PO#:

- BELOW KNEE & THIGH COMPONENT

Measure & Order Form

Company:

Date:
Phone:

Contact Name:
Patient:

Sex:

Age:

Ht:

Wt:

Bill-To Name & Address:
Ship-To Name & Address:

MEASURING INSTRUCTION OPTIONS
CATALOG: Page 68 for standard size

WEB: Scan QR code

Thigh Component and Below Knee
measuring instructions.

PRODUCT INFORMATION
*
Color:
LEFT LEG
Size:
Length:

Black

Beige

Thigh Component (TC)

Below Knee (BK)

RIGHT LEG

Foot Size:

*

Color:

Size:

Beige

Size:

Size:

Item #:

Black

Thigh Component (TC)

Below Knee (BK)

Item #:

Length:

Item #:
*

EMAIL: [e-mail]

OR visit BiaCare.com

Item #:
Foot Size:

(See page 53 for foot sizing)

if no color is selected, black will be shipped.

SIZING CHART & ITEM NUMBERS
F
E
D

SMALL

48 - 58
43 - 53
38 - 48

BLACK 1101 - TC
BEIGE 1111 - TC

C
B
A

LENGTH (CM)
REG: 30 - 36
TALL: 36 - 42

SMALL

29 - 39
24 - 34
20 - 29

(See page 53 for foot sizing)

COMPREFIT - TC

MEDIUM

56 - 66
51 - 61
46 - 56

64 - 74
58 - 68
53 - 63

LARGE

X - LARGE

1102 - TC

1103 - TC

1104 - TC

1112 - TC

1113 - TC

1114 - TC

COMPREFIT - BK REGULAR

MEDIUM

34 - 44
29 - 39
21 - 30

LARGE

39 - 49
33 - 43
25 - 36

48 - 58
41 - 51
32 - 42

XX - LARGE

55 - 65
44 - 55
33 - 43

BEIGE 1111 - BKR 1112 - BKR 1113 - BKR 1114 - BKR 1115 - BKR

C1
C
B
A

29 - 39
26 - 36
21 - 31
20 - 29

COMPREFIT - BK TALL
48 - 58
39 - 49
34 - 44
35 - 45
31 - 41
45 - 55
36 - 46
25 - 35
30 - 40
32 - 42
25 - 36
21 - 30

BEIGE 1111 - BKT 1112 - BKT

•

X - LARGE

BLACK 1101 - BKR 1102 - BKR 1103 - BKR 1104 - BKR 1105 - BKR

BLACK 1101 - BKT 1102 - BKT 1103 - BKT

BiaCare.com

74 - 84
68 - 78
63 - 73

P: 866.931.0876

•

55 - 65
50 - 60
40 - 50
33 - 43

1104 - BKT 1105 - BKT

1113 - BKT 1114 - BKT 1115 - BKT

F: 866.931.0052

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