BiaCare Product Catalog | Page 17
CompreFit
P: 866.931.0876
F: 866.931.0052
[email protected]
®
- BK
ORDER FORM
PO#:
Date:
Company:
Phone:
Contact Name:
Patient Name:
Sex:
Age:
Ht:
Wt:
Bill-To Name & Address:
Ship-To Name & Address:
PRODUCT INFORMATION
LEFT LEG
ACCESSORIES (additional cost):
RIGHT LEG
SIZE:
SIZE:
Cotton Socks (extra pair) Qty:
LENGTH:
LENGTH:
Silver Socks (pair)
Qty:
ITEM #:
ITEM #:
Strap Extenders
Qty:
COMPREBOOT SIZE:
COMPREBOOT SIZE:
COLOR:
Black
Beige
Note: if no color is selected, black will be shipped.
SIZING CHART & ITEM NUMBERS
REGULAR
Bottom of
Patella
SMALL
C 29 - 39
B 24 - 34
A 20 - 29
MEDIUM
34 - 44
29 - 39
21 - 30
BLACK 1101 - BKR
BEIGE 1111 - BKR
LENGTH (CM)
REG: 30 - 36
TALL: 36 - 42
&
1102 - BKR
1112 - BKR
SMALL
MEDIUM
BLACK 1101 - BKT
BEIGE 1111 - BKT
1102 - BKT
1112 - BKT
C1
C
B
A
32 - 42
29 - 39
24 - 34
20 - 29
37 - 47
34 - 44
29 - 39
21 - 30
LARGE
X-LARGE XX-LARGE
39 - 49
33 - 43
25 - 36
48 - 58
41 - 51
32 - 42
55 - 65
44 - 55
33 - 43
1103 - BKR 1104 - BKR 1105 - BKR
1113 - BKR 1114 - BKR 1115 - BKR
TALL
LARGE
X-LARGE XX-LARGE
51 - 61
48 - 58
41 - 51
32 - 42
58 - 68
55 - 65
44 - 55
33 - 43
1104 - BKT
1114 - BKT
1105 - BKT
1115 - BKT
42 - 52
39 - 49
33 - 43
25 - 36
1103 - BKT
1113 - BKT
COMPREBOOT
SMALL
REGULAR
I 28 - 36
J 22 - 26
K 14 - 18
LONG
28 - 36
22 - 26
19 - 23
MED/LARGE
REGULAR
39 max
30 max
18 - 20
LONG
39 max
30 max
23 - 25
XL/XXL
REGULAR
44 max
33 max
20 - 22
LONG
44 max
33 max
25 - 27
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