Get Ez Custom Measurement Form For Circular Knit Stockings

Filling out the EZ Custom Measurement Form for Circular Knit Stockings online is a straightforward process designed to ensure you receive the correct product tailored to your needs. This guide will walk you through each section of the form, making it simple to provide the necessary information.

Follow the steps to complete your measurement form effectively.

1. Click ‘Get Form’ button to access the form and open it in the editor.
2. Begin by entering your account information, including your account number, date, account name, contact details, shipping address, phone number, fax number, patient ID, and purchase order number. Ensure all details are accurate to facilitate processing.
3. Select the compression level that applies to you from the options provided: 20-30 mmHg, 30-40 mmHg, or 40-50 mmHg.
4. Indicate your choice of Juzo product styles, such as Juzo Hostess (AD & AG), Juzo Soft, or Juzo Dynamic, by marking the corresponding boxes.
5. Proceed to the circumference measurements section. Accurately measure and fill in the required circumferences as specified for different parts of the body.
6. In the order information section, specify if the order is for a pair or individual piece(s) by marking the respective option. Indicate if it is for the left or right extremity.
7. Complete the foot portion preferences by selecting from options such as closed toe or open toe. If you have special requests, be sure to note them in the designated section.
8. Record the lengths taken on the medial side of the leg for both left and right sides, as instructed.
9. Choose your preferred color options for the stockings from the provided list. Be sure to check all your selections.
10. Lastly, enter the re-order number, if applicable, and provide the prescribing physician's details followed by the desired quantity.
11. Once all sections are completed, review your entries to ensure accuracy. Save the changes, download the form, print it for your records, or proceed to share it as needed.

Start completing your EZ Custom Measurement Form for Circular Knit Stockings online today for a customized fitting experience.