Get Custom Scoliosis / Kyphosis Orthometry Form Order # - Orthomerica

Filling out the Custom Scoliosis / Kyphosis Orthometry Form is essential for ensuring proper order processing. This guide will walk you through each section, providing clear directions to make the process straightforward and efficient.

Follow the steps to complete your form accurately and efficiently.

1. Press the ‘Get Form’ button to access the Custom Scoliosis / Kyphosis Orthometry Form.
2. In the Patient Information section, fill in your ID or Name, Gender, Height, Weight, Age, and Diagnosis. Ensure all information is accurate to avoid delays.
3. Select the Materials required. Choose one of the following finished thickness options: 1/8', 5/32', or 3/16'. Indicate if you require either Co-Poly, LDPE, or an Aliplast Liner.
4. In the Scoliosis Design section, select your preferred design from options including Low Profile TLSO, Milwaukee, and others. Provide specific details if your design is marked as 'Other'.
5. Proceed to the Kyphosis Design section and select from the available options such as Low Profile TLSO or High Profile. Indicate if you will be sending X-rays for corrections.
6. Fill out the Customer Information section, including the Date, Date Required, PO number, Company Name, Shipping Address, Contact Name, Contact Phone, and Shipping Method.
7. Indicate any special instructions for Order #, including special trim lines, pad placements, and any required window cut-outs.
8. In the Corrective Pads section, select the appropriate pads you will need for lumbar, thoracic, and axillary areas. Confirm where they should be applied according to the X-rays.
9. For Milwaukee Super Structure details, choose between High Profile or Low Profile. Specify if the pads should be attached to upright sections or floating.
10. Fill in the Measurements section by providing anatomical and finished trims for all specified body parts. Ensure accurate measures to avoid errors in orthosis fitting.
11. Finally, review your entire form for completeness and accuracy. Save your changes, then download, print, or share the form as needed.

Complete your Custom Scoliosis / Kyphosis Orthometry Form online today for efficient processing.