Get Account Number: 4057807 (example Pt/ot/pta) Date: Foot Caps Order Form Elvarex, Elvarex Plus

Filling out the Foot Caps Order Form for Elvarex and Elvarex Plus can be straightforward with the right guidance. This comprehensive guide will provide you with the necessary steps to complete the form accurately and efficiently, ensuring that all required details are included.

Follow the steps to complete the Foot Caps Order Form accurately.

1. Click the ‘Get Form’ button to access the Foot Caps Order Form, allowing you to open it in the online editor.
2. Enter the account number in the designated field, which should read '4057807 (example PT/OT/PTA)'. Ensure the account number is correct to avoid processing delays.
3. Fill in the 'Date' field with the current date of the order to keep track of the submission timeline.
4. Choose the quality of the foot caps desired: Elvarex, Elvarex Plus, or Elvarex Soft Seamless. Click the corresponding checkbox to indicate your selection.
5. Indicate the size option for the 'Small Toe Open' section by selecting 'Left' or 'Right', and specify the desired measurements (0.5cm) next to the chosen option.
6. Select a color for the foot caps from the available options: Beige, Cocoa, or Grey. Ensure the color choice is marked clearly.
7. In the 'Quantity/Class' section, choose the quantity required by entering the number of pairs and selecting the relevant cut information if necessary.
8. For compression level, select from CCL1, CCL2, or CCL3 as per the medical requirement, ensuring all necessary circumferences for Elvarex Plus are provided.
9. Fill in the circumference measurements in centimeters for parts labeled 'cZ Top', 'cX Bottom', and additional length measurements such as 'Length medial' and 'Length lateral'.
10. Review all the entered information carefully to ensure accuracy and completeness before finalizing the document.
11. Once completed, you can save changes, download the form for your records, print the document, or share it as required.

Complete your Foot Caps Order Form online today for a smooth ordering experience.