Get Juxtalite Order Form

This guide provides step-by-step instructions to assist users in completing the Juxtalite Order Form online. By following these clear and concise steps, users can efficiently manage their order and ensure all necessary information is correctly submitted.

Follow the steps to successfully fill out the Juxtalite Order Form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Enter the facility name in the designated field at the top of the form. This is important for proper order processing.
3. Provide the contact name of the individual responsible for the order to ensure communication is directed appropriately.
4. Select the preferred form of payment. Options include COD or Purchase Order. Make sure to check the appropriate box.
5. Fill in the date of the order along with contact details, including phone number and fax number. This information is crucial for follow-up.
6. Provide the email address to receive order confirmations and communications.
7. Input payment card details if applicable, including card number, card holder’s name, expiration date, and billing address.
8. Enter the account number and purchase order number if applicable, as this will help track your order.
9. Fill in the patient name and facility reference to ensure that the order is associated with the correct individual.
10. If the shipping address differs from the facility address, provide the shipping address in the specified fields.
11. Choose the shipping method that best meets your needs, such as Ground, 3 Day, 2 Day, or Next Day options.
12. Take measurements of the patient’s limb size as instructed, ensuring accuracy for proper fitting of garments. Record these measurements in the appropriate fields.
13. Complete the legging measurements and foot piece measurements as applicable to the order, following the size charts provided in the form.
14. Once all fields are completed and checked for accuracy, users can save changes, download, print, or share the form as necessary.

Complete your documents online today to expedite your order processing.