BiaCare Product Catalog | Page 33

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PO#:

ORDER FORM

Contact:

Company:

Phone:

Date:

Patient Name:

Age:

Ht:

Wt:

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

PRODUCT INFORMATION

LEFT LEG

RIGHT LEG

SIZE:

SIZE:

LENGTH:

LENGTH:

ITEM #:

ITEM #:

COMPREBOOT SIZE:

COMPREBOOT SIZE:

SIZING & ITEM NUMBERS
Measuring instructions on page 85

C1
C
B
A

SMALL

MEDIUM

LARGE

32 - 42
29 - 39
24 - 34
20 - 29

38 - 48
34 - 44
29 - 39
21 - 30

42 - 52
39 - 49
33 - 43
25 - 36

SHORT 1501 - BKS 1502 - BKS 1503 - BKS

XLARGE XXLARGE
51 - 61
48 - 58
41 - 51
32 - 42

58 - 68
55 - 65
44 - 55
33 - 43

1504 - BKS

1505 - BKS

REG 1501 - BKR 1502 - BKR 1503 - BKR 1504 - BKR 1505 - BKR
TALL 1501 - BKT

I
J
K

1502 - BKT

SMALL
REGULAR LONG
28 - 36
28 - 36
22 - 26
22 - 26
14 - 18
19 - 23

1503 - BKT

1504 - BKT

COMPREBOOT
MED/LRG
REGULAR LONG
39 max 39 max
30 max 30 max
18 - 20
23 - 25

1505 - BKT

XL/XXL
REGULAR LONG
44 max 44 max
33 max 33 max
20 - 22
25 - 27

Foot measuring instructions on page 45

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