BiaCare Product Catalog | Page 9

ORDER FORM

[e-mail] • P: 866.931.0876 • F: 866.931.0052

PO#:

Company:

Phone:

Contact:

Date:

Patient Name:

Age:

Ht:

Wt:

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

PRODUCT INFORMATION
ARM

LEFT

OVERSLEEVE (included):

RIGHT

Note: if no color is specified, a black OverSleeve™
will be included.

SIZE:

Black

Pink

Leopard

Navy

Tie-Dye

Blue Horizon

LENGTH:
ITEM #:

SIZING & ITEM NUMBERS
Measuring instructions on page 85
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

XXLARGE
44 - 54
39 - 49
36 - 43
19 - 22

SHORT 2631-ARS-L

2632-ARS-L

2633-ARS-L

2634-ARS-L

2635-ARS-L

REG 2631-ARR-L

2632-ARR-L

2633-ARR-L

2634-ARR-L

2635-ARR-L

LONG 2631-ARL-L

2632-ARL-L

2633-ARL-L

2634-ARL-L

2635-ARL-L

SHORT 2631-ARS-R

2632-ARS-R

2633-ARS-R

2634-ARS-R

2635-ARS-R

C
B1
B
A

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

LEFT

RIGHT

REG 2631-ARR-R 2632-ARR-R 2633-ARR-R 2634-ARR-R 2635-ARR-R
Measure length along
dorsal aspect

LONG 2631-ARL-R

2632-ARL-R

2633-ARL-R

2634-ARL-R

2635-ARL-R

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