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Get Afo Gauntlet Order Form - Acor
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How to fill out the AFO GAUNTLET ORDER FORM - Acor online
Filling out the AFO Gauntlet Order Form - Acor online can seem daunting, but with this guide, you will have clear instructions to complete each section seamlessly. This form is essential for ordering custom orthopedic devices, ensuring the correct specifications for your needs.
Follow the steps to complete your order form efficiently.
- Click ‘Get Form’ button to obtain the form and access it in your preferred editing tool.
- Begin by providing the billing company information, including the company name, address, city, and phone number. Ensure that all details are accurate.
- Next, fill in the shipping company information. Include the company’s name, address, city, state, phone number, and fax number. Verify that these details align with the intended delivery.
- In the section labeled 'Date,' enter the current date, and select your preferred shipping method between FedEx and UPS, specifying the service level.
- Fill in the Purchase Order (PO) number if applicable, and choose the desired style and color of the gauntlet.
- Identify the patient by entering their name and customer number. If this information is absent, check with the appropriate party for accuracy.
- Indicate the diagnosis to ensure proper customization of the gauntlet and specify the height and amputation filler requirements.
- Consider whether you would like ACOR's Tech Support Team to contact you regarding this order by answering 'Yes' or 'No'.
- Complete the foot and leg line specifications, clarifying whether any corrections are needed.
- Select the orthoses option, lining type, and reinforcement material as mandated by the order requirements.
- Specify any special gauntlet modifications desired, and make note of any additional special requirements if they exist.
- Once all sections are filled out, review your inputs for accuracy, and then proceed to save changes, download, print, or share the completed form as necessary.
Take the next step in your journey by completing the AFO Gauntlet Order Form online today.
Ankle-foot orthosis (AFO) is a commonly used orthosis in patients having weakness in the ankle dorsiflexor or plantarflexor muscles due to several disorders such as stroke, cerebral palsy, spinal cord injury, and peripheral nerve injury.
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