Day P.M. 2-Day A.M. 2-Day P.M. Billing Account #: Shipping Account #: Billing Address: Shipping Address: City: City: State Zip Zip: (If no preference is indicated, this order will be shipped 2 Day P.M.) Note: We do not ship products directly to patients. PLEASE FOLLOW STEP-BY-STEP CAST PROTOCOL INSTRUCTIONS The Townsend Full Shell BK Orthosis is designed to fit directly over your patients prosthetic socket. The thigh and tibial shell will integrate with any conventional or vac.

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How to fill out the Thuasne OF004 online

Filling out the Thuasne OF004 form is an essential step in ensuring the accurate ordering of specialty bracing solutions. This guide provides a thorough, step-by-step approach to assist users in completing the form correctly and efficiently.

Follow the steps to complete the Thuasne OF004 form accurately.

  1. Click the ‘Get Form’ button to access the Thuasne OF004 online and open it in your preferred editor.
  2. Enter the account contact information, including the name, email, and phone number of the person completing the form.
  3. Fill in the billing and shipping sections. Enter the purchase order number and select the shipping preference from the provided options. Make sure to provide billing and shipping account numbers, as well as the respective addresses, cities, states, and zip codes.
  4. Indicate the fit date and provide the patient's details, including their last name, first name, age, weight, height, and leg preference.
  5. Specify the patient's clinical diagnosis and any relevant surgeries, along with the current assistive devices the patient uses.
  6. Follow the casting protocol instructions closely, ensuring to complete each step, such as casting the patient and marking key points for alignment.
  7. Once the cast has set, proceed to fill out the thigh shell and tibia shell length options as well as the number of tibia straps required.
  8. Select any required locking joint options, brace colors, and fabric inlay selections, if applicable.
  9. Review all the entered information for accuracy and completeness before finalizing.
  10. Save the changes made to the document, and then proceed to download, print, or share the completed form as necessary.

Complete your Thuasne OF004 form online today for efficient ordering!

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