Get Shiley Custom Trach Template

Filling out the Shiley Custom Trach Template efficiently can ensure that medical professionals have the accurate specifications needed for patients. This guide provides a clear, step-by-step approach to assist you in completing the form online.

Follow the steps to accurately fill out the Shiley Custom Trach Template.

1. Press the ‘Get Form’ button to access the Shiley Custom Trach Template in your preferred online editor.
2. Indicate whether this is a new order or a re-order by checking the appropriate box at the top of the form. If you select re-order, please ensure to list the previous lot number to streamline the process.
3. Specify the number of custom tracheostomy tubes you are ordering by entering the quantity in the designated field.
4. Select any accessories included with each tube, ensuring to mark two obturators if they are required.
5. Complete the sections for physician name, patient name, and purchaser order number by filling in the respective fields with accurate information.
6. Enter shipping instructions, including the address, city, state, and zip code to ensure timely delivery.
7. In the size section, choose the specific sizes for both inner diameter (I.D.) and outer diameter (O.D.) as provided. Note the standard length options available.
8. For flange selection, choose between the neonatal or pediatric options, and select the rotation direction as applicable.
9. Fill in the cannula curve specifications, selecting either standard or modified, and input the required measurements.
10. Complete the fenestration details by noting both the location and size modifications as necessary for uncuffed tubes.
11. Review all entered information for accuracy. Finally, save changes, download, print or share the completed form as needed.

Start filling out the Shiley Custom Trach Template online today to ensure prompt and accurate orders!