We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Prosthetic Socket Measurement Form

Get Prosthetic Socket Measurement Form

HUTNICK REHAB SUPPORT SERVICES, INC. TRANSFEMORAL SOCKET TO MEASUREMENTS FABRICATION FORM FACILITY: PATIENT S NAME: ADDRESS: LEFT CITY: STATE: AGE: SEX: HGT: WGT: ZIP: PHONE: / / COLOR: SWATCH #:.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Prosthetic Socket Measurement Form online

Completing the Prosthetic Socket Measurement Form accurately is essential for the proper fabrication of a prosthetic device. This guide will provide you with a detailed, step-by-step approach to filling out the form online, ensuring you have all the necessary information at hand.

Follow the steps to complete the form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling out the facility information at the top of the form. Make sure to provide the name of the facility clearly.
  3. Enter the patient's information, including their name, address, city, state, zip, phone number, age, sex, height, and weight.
  4. Indicate the preferred color and swatch number for the prosthetic device.
  5. Include the practitioner's name and the activity level of the patient.
  6. Select whether the prosthesis is for the left, right, or bilateral leg as applicable.
  7. Fill in the email address for communication regarding the order.
  8. Provide the purchase order number, order date, date needed, and preferred shipping method.
  9. Proceed to the measurement section. Enter the lengths required to the distal femur and distal end, along with the necessary soft tissue and bony measurements.
  10. Describe the distal end contour and any components that need to be attached.
  11. Indicate any desired reduction goals and add additional instructions if necessary.
  12. Complete the socket brim design section by selecting the appropriate options from the provided list.
  13. Lastly, review all entered information for accuracy before saving changes, downloading, printing, or sharing the form.

Fill out your Prosthetic Socket Measurement Form online today for efficient and accurate service.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

guidelines for measurement of amputation stump...
Accurate measurement of limb length before amputation surgery aids the surgeon in the...
Learn more
Development of Subischial Prosthetic Sockets with...
Current transfemoral prosthetic socket designs encase the hip joint and portions ... scans...
Learn more
Coronary catheterization - Wikipedia
A coronary catheterization is a minimally invasive procedure to access the coronary...
Learn more

Related links form

Ritual Amp Ceremonies - Sons Of Union Veterans Of The Civil War - Suvcw Application Form Class And Type Rating APPLICATION FOR INITIAL/AMENDMENT/RENEWAL OF ... - Belgium LA DESIGNATION D''UN MANDATAIRE - 5030 Fedimbo Belgium

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Measuring for a prosthetic liner requires attention to the dimensions of the residual limb, similar to measuring for the socket itself. The measurements ensure that the liner fits smoothly, providing an additional layer of comfort between the limb and the socket. The Prosthetic Socket Measurement Form can guide you in accurately capturing these dimensions for the best results.

The socket of a prosthetic device serves as the foundation that supports and secures the prosthetic limb to the user. It's critical that the socket fits correctly to provide comfort and mobility. Utilizing a Prosthetic Socket Measurement Form allows technicians to gather accurate data, ensuring a better socket fit for optimized use.

Making a prosthetic leg socket involves creating a mold of the residual limb, followed by crafting the socket using specialized materials. This process ensures the socket is tailored to the user’s shape, which is why the Prosthetic Socket Measurement Form is so important. A precise fit can significantly improve the overall success of the prosthetic leg.

The interface socket of a prosthesis is the part that directly engages with the residual limb. It plays a vital role in comfort and stability during movement. Properly completing a Prosthetic Socket Measurement Form can ensure that the interface socket fits snugly and performs effectively, reducing discomfort and enhancing mobility.

A prosthetic device consists of several components, including the socket, pylon, foot, and various fixings. The socket is the part that connects to the limb, while the pylon is the rod that provides structure. Understanding these parts helps users appreciate the importance of accurate measurements, like those found on a Prosthetic Socket Measurement Form.

Measuring for prosthetics involves taking specific dimensions of the residual limb to ensure a proper fit. Typically, a Prosthetic Socket Measurement Form will include measurements for length, circumference, and shape of the limb. These precise measurements are crucial to creating a prosthetic that is comfortable and effective.

A TF socket, or transfemoral socket, is specifically designed for individuals who have undergone amputation above the knee. This socket supports the thigh and connects the prosthetic leg securely. Proper measurement through a Prosthetic Socket Measurement Form is essential to create a functional and comfortable fit for each user.

The socket in prosthetics is the part that interfaces with the residual limb. It is custom-made to provide a secure fit and comfort for the user. Accurate measurements are crucial, and using a Prosthetic Socket Measurement Form helps ensure that the socket is designed optimally for each individual's needs.

Length: Measure from bottom edge of prosthetic knee to top edge of foot shell. Heel Strike Length: Ask patient to put all weight into their heel to simulate max heel strike. Measure from rear edge of prosthetic knee to top rear edge of foot shell.

Wear the prosthesis for a maximum of 2 hours, with up to 1/2 hour of that standing and/or walking. These amounts are maximums, and need not all be done at once. Examine the limb after every hour of wearing, and/or after every 15 minutes of standing or walking.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Fill Prosthetic Socket Measurement Form

Circumference dimensions in distance to. We have tried to make measuring as quick and intuitive as possible, needing only the length and circumference to manufacture the cover. A measurement on skin is adequate for sizing, but can be combined with a measurement over a silicone liner to best choose a size. Use the Össur Leg Measurement form to record measurements.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Prosthetic Socket Measurement Form
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232