Get Printable Birvonia Custom Trach Form

Filling out the Printable Birvonia Custom Trach Form is an important step for individuals requiring customized tracheostomy solutions. This guide will walk you through the process of completing the form online with clear, step-by-step instructions.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in your editing tool.
2. Begin with the shaft length section. Specify both proximal and distal shaft lengths. The first field requires a measurement between 5mm and 60mm, while the second needs a length between 30mm and 140mm.
3. Fill out the shaft details. Indicate either the inner diameter (I.D.) within the range of 2.5mm to 9.5mm or the outer diameter (O.D.).
4. Select your preferred connector type. You may choose between a swivel connector with an I.D. of 2.5 to 9.5mm or a fixed connector with an I.D. of 2.5 to 6.0mm.
5. Specify the neck flange options. Indicate the desired length and select between available neck flange sizes ranging from 2.5mm to 9.5mm.
6. Choose the cuff type next. Select the appropriate option based on whether you need a TTS™ tight to shaft cuff, Aire-Cuf® for pediatric or adult sizes, ensuring you meet the specified diameter compatibility.
7. If applicable, fill in the specialty shaft details, such as standard curved or reinforced options intended for pediatric or adult use.
8. Designate any optional features needed such as proximal or distal cuff types or a talk attachment. Make sure to provide necessary measurements and specify cuff distances while adhering to the defined standards.
9. Finalize the form by entering the approval section. Print clearly the name of the hospital or clinic, date, clinician's signature and credentials, patient/client ID, purchase order number, and select your desired service type.
10. Save your changes, download the completed form, and make sure to print or share it as necessary for processing.

Complete your forms online today to ensure the necessary customized solutions are efficiently provided.