BiaCare Product Catalog | Page 42
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CompreFLEX
™
ORDER FORM
PO#:
- BK & TC
Date:
Company:
Phone:
Contact Name:
Patient Name:
Sex:
Age:
Ht:
Wt:
Bill-To Name & Address:
Ship-To Name & Address:
PRODUCT INFORMATION
LEFT LEG:
Below Knee (BK)
RIGHT LEG:
Thigh Component (TC)
Thigh Component (TC)
Below Knee (BK)
Size:
Size:
Size:
Size:
Length:
Item #:
Length:
Item #:
Item #:
CompreBoot Size:
Item #:
CompreBoot Size:
(See page 41 for foot sizing)
(See page 41 for foot sizing)
SIZING CHART & ITEM NUMBERS
Gluteal Fold
(or desired length)
G1 LENGTH (CM)
REG: 20 - 25
TALL: 25 - 30
COMPREFLEX - TC
F
E
D
SMALL
48 - 58
43 - 53
38 - 48
MEDIUM
56 - 66
51 - 61
46 - 56
LARGE
64 - 74
58 - 68
53 - 63
X - LARGE
74 - 84
68 - 78
63 - 73
RIGHT
REG 1401-TCR-R 1402-TCR-R 1403-TCR-R 1404-TCR-R
TALL 1401-TCT-R 1402-TCT-R 1403-TCT-R 1404-TCT-R
LEFT
REG 1401-TCR-L 1402-TCR-L 1403-TCR-L 1404-TCR-L
TALL 1401-TCT-L 1402-TCT-L 1403-TCT-L 1404-TCT-L
COMPREFLEX - BK
LENGTH (CM)
REG: 30 - 36
TALL: 36 - 42
C1
C
B
A
X - LARGE XX - LARGE
46 - 56
54 - 64
SMALL
29 - 39
MEDIUM
34 - 44
LARGE
40 - 50
29 - 39
34 - 44
40 - 50
46 - 56
54 - 64
24 - 34
29 - 39
34 - 44
39 - 49
44 - 55
16 - 26
21 - 30
26 - 36
31 - 41
36 - 46
REG 1401 - BKR