Get Ak 3s Prosthetics - Fillauer

Filling out the AK 3S Prosthetics - Fillauer form online is essential for ensuring accurate measurements and specifications for prosthetic devices. This guide will walk you through each section and field of the form, providing clear instructions to help you complete it efficiently.

Follow the steps to complete the AK 3S Prosthetics - Fillauer form online.

1. Press the ‘Get Form’ button to access the document and open it in the online editor.
2. Fill in the Practitioner’s information, including their contact number, fax number, address, and branch name.
3. Enter the Purchase Order (PO) number and the date of the request.
4. Specify the shipping method by completing the 'Ship Via' section and providing the recipient's address, city, state, and zip code.
5. In the Patient Information section, provide the patient's name, age, gender, weight, and height.
6. Complete the Diagnosis (Dx) and degree of lordosis fields by selecting the appropriate options.
7. Indicate the level reduction and specify the model as either modified or unmodified.
8. Fill out the reduction factors and goals per the required anatomical measurements and reductions for the prosthesis.
9. In the notes/special instructions section, provide any additional information needed for the patient's care.
10. Once all fields are completed, you can save your changes, download, print, or share the form as required.

Complete the AK 3S Prosthetics - Fillauer form online to ensure accurate and timely processing of your request.