BiaCare Product Catalog | Page 19

CompreFit PLUS - BK P: 866.931.0876 F: 866.931.0052 [email protected] ® 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 SMALL C 24 - 34 B 19 - 29 A 15 - 24 Bottom of Patella MEDIUM 29 - 39 24 - 34 16 - 25 BLACK 1151 - BKR 1152 - BKR BEIGE 1161 - BKR 1162 - BKR LARGE X-LARGE XX-LARGE 34 - 44 28 - 38 20 - 31 43 - 53 36 - 46 27 - 37 50 - 60 39 - 50 28 - 38 1153 - BKR 1154 - BKR 1155 - BKR 1163 - BKR 1164 - BKR 1165 - BKR TALL C1 C B A LENGTH (CM) REG: 30 - 36 TALL: 36 - 42 SMALL 24 - 34 21 - 31 16 - 26 15 - 24 BLACK 1151 - BKT BEIGE 1161 - BKT MEDIUM LARGE 1152 - BKT 1162 - BKT 1153 - BKT 1163 - BKT 29 - 39 26 - 36 20 - 30 16 - 25 & 34 - 44 30 - 40 25 - 35 20 - 31 X-LARGE XX-LARGE 42 - 53 39 - 49 31 - 41 27 - 37 50 - 60 45 - 55 35 - 45 28 - 38 1154 - BKT 1164 - BKT 1155 - BKT 1165 - 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 16