BiaCare Product Catalog | Page 11

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PO#:

ORDER FORM

Company:

Phone:

Contact:

Date:

Patient Name:

Age:

Ht:

Wt:

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

PRODUCT INFORMATION
ARM

LEFT

OVERSLEEVE (additional cost):

RIGHT

The OverSleeve™ helps protect the hook and loop tabs.

SIZE:
LENGTH:

Black

Pink

Leopard

Navy

Tie-Dye

Blue Horizon

ITEM #:

SIZING & ITEM NUMBERS

Measuring instructions on page 85

SMALL
23 - 32
22 - 30
20 - 27
14 - 17

MEDIUM
28 - 37
26 - 34
24 - 31
15 - 18

LARGE
33 - 43
30 - 39
28 - 35
16 - 19

XLARGE
39 - 49
35 - 44
32 - 39
18 - 20

SHORT

1501-ARS-L

1502-ARS-L

1503-ARS-L

1504-ARS-L

REG

1501-ARR-L

1502-ARR-L

1503-ARR-L

1504-ARR-L

LONG

1501-ARL-L

1502-ARL-L

1503-ARL-L

1504-ARL-L

SHORT

1501-ARS-R

1502-ARS-R

1503-ARS-R

1504-ARS-R

REG 1501-ARR-R

1502-ARR-R

1503-ARR-R

1504-ARR-R

1502-ARL-R

1503-ARL-R

1504-ARL-R

C
B1
B
A

Measure length along
dorsal aspect

LONG

1501-ARL-R

LEFT

RIGHT

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