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Get Jobst Elvarex Order Form 2020-2025
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How to fill out the Jobst Elvarex Order Form online
Filling out the Jobst Elvarex Order Form online can be a straightforward process when you follow clear instructions. This guide will walk you through each section of the form to ensure all necessary information is captured accurately.
Follow the steps to complete the Jobst Elvarex Order Form online easily.
- Click 'Get Form' button to obtain the form and open it in the editor.
- Begin by filling in the date and the hospital purchase order number at the top of the form. This information helps identify the order.
- Provide the patient’s name and date of birth. Ensure that the details are accurate to avoid any discrepancies.
- Enter the name of the person who measured the patient along with their telephone number. This contact information is crucial for any follow-up regarding the order.
- Fill in the delivery address where the items are to be shipped. If different, also provide the invoice address.
- In the sections labeled for the right and left foot, enter the circumference measurements in centimeters (cm). You will need to take three measurements for each foot: A - Circumference, A1 - Circumference, and Length. Ensure precision as these measurements are vital for the correct fit.
- Specify the quantity required for each Elvarex product version (1, 2, or 3) for both the left and right foot. Select the appropriate compression level (e.g., 18-21 mmHg, 23-32 mmHg, or 34-46 mmHg) and color preference (e.g., beige or black).
- Review all entered information to confirm accuracy. It is important that the right details are submitted to ensure the correct order fulfillment.
- Once you have completed the form, you can save the changes made, and choose to download, print, or share the form as needed.
Complete your Jobst Elvarex Order Form online today to ensure timely processing of your order.
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