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