Listen. Imagine. Deliver.
2 0 1 2 C ATA L O G COMPRESSION WEAR
•
THERAPY SUPPLIES
FoamSleeve™ Feather Light Mild Compression
ChipSleeve™
CompreFit®
Multi-Pressure Foam for Fibrotic Relief
Chronic Venous Insufficiency Relief Medicare Covered for Ulcers
NEW
3 4 4 ARM 4 BK 4 STANDARD
TC TH CUSTOM
OverSleeves™ Added Compression & Flair
9 4 ARM 4 BK 4 TC 4 TH 4 STANDARD 4 CUSTOM
5
4 ARM 4 BK TC 4 TH 4 STANDARD 4 CUSTOM
ARM 4 BK 4 TC TH 4 STANDARD CUSTOM
GeniFit™
CompreShorts™
Genital Edema Containment
Mild Compression & Suport
10
10 GENITAL SUPPORT& COMPRESSION 4 STANDARD CUSTOM
All products are (unless indicated otherwise)
TRUNCAL & THIGH SUPPORT & COMPRESSION
4 STANDARD
4 CUSTOM
• Free of natural latex
CompreFit® PLUS-BK Wound Care Compression with Foam Liner for Added Comfort
CompreFlex™ Soft Comfortable Daytime Lymphedema Compression
CompreSleeve™
The Closest thing to Bandage Wrapping™
NEW
7 8
6 ARM 4 BK 4 STANDARD
TC TH CUSTOM
MedaFit
™
Guaranteed for Life*
ARM 4 BK 4 TC 4 TH 4 STANDARD 4 CUSTOM
MedAssist
™
Correct Fit for any Size Guaranteed**
4 ARM 4 BK 4 STANDARD
TC 4 TH CUSTOM
COMPRESSION ACCESSORIES CompreKnee™............................15 CompreFit® Foamliner..............15 Cotton / Silver Socks.................18 MedaHand™ / MedaGlove™......16 CompreBoot™ / CompreBoot™ PLUS................16 Cotton Liners.............................17
THERAPY SUPPLIES
11 4 ARM 4 BK 4 STANDARD
TC 4 TH CUSTOM
13 4 ARM 4 BK 4 TC 4 TH STANDARD 4 CUSTOM
Bandages...................................19 Gauze, Padding & Tape............20 Foam...........................................21 Stockinette & Retainer..............22 *See Limited Lifetime Warranty for details. **See Fit Guarantee for details.
• Can be machine washed & dried • Made in the USA
FoamSleeve
™
Fo a m S l e e v e . c o m
Feather Light Mild Compression • • • •
Directional WaveFoam II™ to stimulate superficial lymphatics and facilitate efficient fluid evacuation Ideal for patients with fragile skin, limited dexterity or limited range of motion Can be used as a bandage liner, or as a compression garment with optional OverSleeve™ Built-in Donning Loops • Exceptionally light weight and breathable
FoamSleeve™ - Arm • • • •
Provides mild, gradient compression from hand to axilla Includes thumb and lateral shoulder rise 10-20 mmHg with optional OverSleeve™ Pair of cotton liners included
Hand wash / air dry
Measuring form and item numbers on pages 23 - 24
FoamSleeve™ - BK • • • • •
Gentle, gradient compression from toes to below knee Does not constrict below knee 10-20 mmHg with optional OverSleeve™ Exceptionally lightweight Pair of seamless cotton stockings included
Measuring form and item numbers on pages 25 - 26
Options & Accessories
OverSleeve™ pg. 9 ph: 866.931.0876
BiaFORM™ pg. 19 3
Silver Socks pg. 18 Cotton Liners pg. 17
FingerFORM™/ ToeFORM™ pg.19 fax: 616.931.0052
NEW
ChipSleeve
™
ChipSleeve.com
Multi-Pressure Foam for Fibrotic Relief • • • •
Open cell foam chips provide massaging effect on superficial lymphatics, helping to soften fibrotic areas Directional channels facilitate effecient drainage of lymph fluid Conforming design and materials ensures proper fit • Moisture wicking, anti-odor, soil release fabric Ideal for use as bandage liner or compression garment
ChipSleeve™ - Arm • • • •
Provides mild, gradient compression from hand to axilla Includes thumb and lateral shoulder rise 15-25 mmHg compression with OverSleeve™ (included) Pair of cotton liners included
Measuring form and item numbers on pages 23 - 24
Custom Sizes Available
ChipSleeve™ - BK • • • •
Gentle, gradient compression from toes to below knee Does not constrict below knee 15-25 mmHg compression with OverSleeve™ (included) Pair of seamless cotton stockings included
Measuring form and item numbers on pages 25 - 26
Custom Sizes Available
ChipSleeve™ - TH • • • •
Gentle, gradient compression from toes to groin Includes lateral rise over hip 15-25 mmHg compression with OverSleeve™ (included) Pair of cotton liners included
Measuring form and item numbers on pages 27 - 28
www.BiaCare.com
4
Custom Sizes Available
[email protected]
CompreFit
®
C o m p r e Fi t . c o m
Chronic Venous Insufficiency Relief • Non-elastic containment and reduction of lower extremity edema • 30-40 mmHg active compression, lower resting compression • Exceptionally durable, yet breathable, light weight design
CompreFit® - BK • • • • •
Medicare covered for ulcers under Code A6545 Effective for day/safe for night Ideal for chronic edema or venous insufficiency Easily worn under most clothing Includes CompreBoot™ foot piece and a pair of seamless cotton stockings
Measuring form and item numbers on pages 29 - 30
CompreFit® - TC • • • • •
Non-elastic support from knee to groin Includes CompreKnee™ knee piece and hip support Easily worn under most clothing Combine with CompreFit™ - BK for full leg compression Pair of cotton liners included
Measuring form and item numbers on pages 31 - 32
ph: 866.931.0876
5
fax: 616.931.0052
CompreFit Plus ®
C o m p r e Fi t . c o m
Wound Care Compression Combines the non-elastic compression of the CompreFit® with a high density, low profile foam liner to provide a soft, evenly distributed compression. Ideal for use on granulation tissue.
CompreFit® Plus - BK • Includes Foamliner for added skin protection • 30-40 mmHg active compression
• Includes CompreBoot™ foot piece and a pair of seamless cotton stockings
Measuring form and item numbers on pages 29 - 30
Options & Accessories
Silver Socks pg. 18 www.BiaCare.com
Strap Extenders pg. 17
CompreBoot™ Plus pg. 16 6
Finger Loops pg. 17
[email protected]
CompreFlex
™
NEW
CompreFlex.com
Soft, Comfortable Daytime Compression • Easier to use than high compression stockings • Easily worn under most clothing • Durable design resists fraying and tearing • Exceptionally comfortable • Highly adjustable, conforming design
CompreFlex™ - BK • Ideal for mild to moderate lymphedema or CVI • Combine with CompreFlex™ - TC for full leg compression • Includes CompreBoot™ compression foot piece and a pair of seamless cotton stockings
Measuring form and item numbers on pages 33 - 34
Custom Sizes Available
CompreFlex™ - TC • Low Stretch support from knee to groin • Combine with CompreFlex™- BK for full leg compression • Includes CompreKnee,™ hip support, and two cotton liners
Measuring form and item numbers on pages 33 - 34
Custom Sizes Available
CompreFlex™ - TH • Comfortable compression from ankle to groin • Available as custom garment only, 2-3 days shipping
ph: 866.931.0876
7
Measuring form and item numbers on pages 53 - 54
fax: 616.931.0052
CompreSleeve
™
CompreSleeve.com
The Closest thing to Multi-Layer Bandaging™
• • • •
Low-stretch compression safe and effective for day or night use Unique cotton/lycra blend mimics short-stretch bandaging Directional WaveFoam II™ for efficient fluid evacuation Highly adjustable, conforming design
CompreSleeve™ - Arm • Ideal for mild to moderate lymphedema • Includes adjustable hand piece, palm foam for dorsum compression, lateral shoulder rise, and pair of cotton liners 20 - 30 mmHg gradient compression
Measuring form and item numbers on pages 23 - 24
CompreSleeve™ - BK • Zipper for easy donning & doffing • Does not constrict below the knee • Includes CompreBoot™ compression foot piece and a pair of seamless cotton stockings
Measuring form and item numbers on pages 39 - 40
CompreSleeve™ - TH • • • • •
Zipper for easy donning & doffing Low-stretch compression from toes to groin Includes lateral hip rise Includes CompreBoot™ compression foot piece and pair of cotton liners Made to order only, 2-3 days shipping
Measuring form and item numbers on pages 43 - 44
www.BiaCare.com
8
[email protected]
OverSleeves
™
BiaCare.com
A Simple, Quick and Low Cost way to add up to 10 mmHg Compression - with a Flair OverSleeve™- Arm • Helps hold garment tabs / straps in place • Protects garment from hair, dirt, and other debris • Covers thumb and hand
Available in the following colors and designs
Custom Sizes Available Measuring form and item numbers on pages 23 - 24
OverSleeve™- Hand & Glove
Leopard
• Comfortable yet firm compression • Available in black only Machine wash / air dry
Navy
Measuring form and item numbers on pages 37 - 38
OverSleeve™- BK • Covers hook and loop straps which may have sharp edges • Open toe • Extends life of compression garment
Pink
by helping keep it clean Custom Sizes Available Measuring form and item numbers on pages 25 - 26
Tie Dye
OverSleeve™- TH • Gives compression garment soft, smooth surface by covering hook and loop tabs & straps
• Open toe
Black
Custom Sizes Available Measuring form and item numbers on pages 27 - 28
ph: 866.931.0876
9
fax: 616.931.0052
GeniFit / CompreShorts ™
™
G e n i Fi t . c o m
Genital Support and Compression • Soft, breathable design to reduce moisture containment
GeniFit™ Compression Pad • Low-cut pad for genital swelling • High-cut pad for genital swelling involving lower abdominal edema
• Breathable mesh pad standard • Barrier fabric pad available for use with incontinence pads
• Available for male and female Custom Sizes Available Measuring form and item numbers on pages 35 - 36
CompreShorts™ • Support and mild compression for truncal & abdominal lymphedema
• Shown with optional GeniFit™ compression pad • Reinforced seams for durability Note: Waist band contains natural latex on sizes 3X and larger Machine wash / air dry
Custom Sizes Available Measuring form and item numbers on pages 35 - 36
www.BiaCare.com
10
[email protected]
MedaFit
™
M e d a Fi t . c o m
Lymphedema Compression Wear Guaranteed for Life* • Highly adjustable compression system • Removable liner & replaceable straps • 30-40 mmHg gradient compression
• WaveFoam™ II with moisture wicking liner • Machine wash & dry
MedaFit™- Arm • • • •
Ideal for stage II/III lymphedema Includes MedaHand™ (MedaGlove™ optional) Includes Unistrap™ for added hand compression Includes donning loop and two cotton liners
Measuring form and item numbers on pages 37 - 38
MedaFit™ - BK • Includes CompreBoot™ Plus and a pair of seamless cotton stockings
• Does not constrict below knee
Measuring form and item numbers on pages 39 - 40
MedaFit™ - TH • Includes CompreBoot™ Plus and pair of cotton liners • Toe to groin gradient compression • Lateral rise over hip
Measuring form and item numbers on pages 43 - 44 *See Limited Lifetime Warranty for details.
ph: 866.931.0876
11
fax: 616.931.0052
MedaFit
™
M e d a Fi t . c o m
MedaFit™ Compression Wear is the only Lymphedema Compression Wear with a Limited Lifetime Warranty*
Replacement Foam Liner • MedaFit™- Arm, BK, & TH • Easily installs into MedaFit™ compression wear • Hook and loop attachment to MedaFit™ compression shell
See price list for item numbers
Replacement Straps • MedaFit™- Arm, BK, & TH • Easily attaches to MedaFit™ compression wear
See price list for item numbers
MedaFit™ - Compression Shell • Includes compression straps and donning loop Foam liner not included
See price list for item numbers *See Limited Lifetime Warranty for details.
www.BiaCare.com
12
[email protected]
MedAssist Custom ™
BiaCare.com
Custom Lymphedema Compression Wear • • • •
Medical grade non-static fabric for exceptional durability Directional WaveFoam II™ or medium density flat foam Designed to provide distal to proximal gradient compression of 30-40 mmHg Gauranteed to fit*
ArmAssist™ • • • • •
Firm, gradient 30-40 mmHg compression from hand to axilla Palm foam for added dorsum compression Zipper panel for easy donning/doffing UniStrap included for additional hand compression Two cotton liners included
Measuring form and item numbers on pages 45 - 46
LegAssist™- BK • Includes CompreBoot™ Plus foot piece and pair of seamless cotton stockings
• Zipper panel for easy donning/doffing • Available in regular and super sizes (over 60 cm circumference) • Upgrade to (optional) custom MedaBoot™
Measuring form and item numbers on pages 47 - 48 *See Fit Guarantee for details.
Options & Accessories
Silver Socks pg. 18 ph: 866.931.0876
FingerFORM™ pg. 19 13
ToeFORM™ pg. 19 fax: 616.931.0052
MedAssist Custom ™
BiaCare.com
Medically Correct Fit for any Size, Guaranteed*
LegAssist™ - LCS™ • Unique Lobule Compression System to lift, support, and compress lobules or other limb deformities
• Extra large adjustment range • Two cotton liners included
Measuring form and item numbers on pages 49 - 51
Shown with LegAssist™- BK
LegAssist™ - TH • Available in regular & super sizes (over 90 cm circumference) • Includes CompreBoot™ Plus foot piece and two cotton liners • Zipper panel for easy on/off
Measuring form and item numbers on pages 53 - 55
MedaBoot™ • Custom compression boot for chronic/acute edema • Added dorsum padding • Breathable, moisture wicking liner • Required for non-standard foot sizes Measuring form and item numbers on pages 41 - 42 *See Fit Guarantee for details.
www.BiaCare.com
14
[email protected]
Compression Accessories BiaCare.com
CompreFit® Foamliner • High density, open cell foam • Breathable, moisture wicking mesh lining • Lycra exterior Measuring form and item numbers on pages 29 - 30
CompreKnee™ • Soft compression for knee area with opening at patella
Measuring form and item numbers on pages 31 - 32
CompreBoot™ Foam Liner • WaveFoam™ II with moisture wicking mesh lining
Measuring form and item numbers on pages 41 - 42
Ankle Pad • Moisture wicking mesh lining • Open cell, WaveFoam™ • For use with CompreBoot™ or bandages Measuring form and item numbers on pages 41 - 42
ph: 866.931.0876
15
fax: 616.931.0052
Compression Accessories BiaCare.com
MedaHand™ • Powernet compression hand piece with WaveFoam™ • 10-20 mmHg, 20-30 mmHg with optional Hand OverSleeve,™ 30-40 mmHg with optional UniStrap™ • Extra foam in palm space for additional dorsum compression Measuring form and item numbers on pages 37 - 38
MedaGlove™ • Ideal for mild/moderate hand edema • 10-20 mmHg, 20-30 mmHg with optional Glove OverSleeve,™ 30-40 mmHg with optional UniStrap™ • Spandex compression hand piece with WaveFoam™ Measuring form and item numbers on pages 37 - 38
CompreBoot™ • Neoprene with hook and loop enclosures provide 20-30 mmHg compression over entire foot
• Forms well around ankle • Open heel Measuring form and item numbers on pages 41 - 42
CompreBoot™ Plus • Includes a foam liner, D-ring straps for 30-40 mmHg
compression, and Gripper Patches for better traction
• Replaceable foam insert and straps Measuring form and item numbers on pages 41 - 42
www.BiaCare.com
16
[email protected]
Accessories BiaCare.com
The Right Accessory for your Compression Needs
UniStrap™ • Neoprene compression strap for added hand/foot compression • Available in black or beige • Cut to length Item #
Description
1902
Black
1912
Beige
CompreFit® - Strap Extender • Adds 10 cm of adjustable range to CompreFit® • Ideal for use when Item # Description one or two straps are too short
1901
Black (One Set)
1901-BP
Black (10 Set Bulk Pack)
1911
Beige (One Set)
1911-BP
Beige (10 Set Bulk Pack)
Finger Loops - CompreFit®& CompreSleeve™ • Aids in donning/doffing • Easy to apply & remove • Ideal for arthritic patients or patients with limited dexterity Item # 1914-10
Description
Item #
Description
CompreFit® Finger Loops enough for one garment
1510
CompreSleeve™ Finger Loops enough for one garment
Cotton Liners - Arm, BK & TH • Soft breathable cotton stockinette liners can be worn under all compression products
ph: 866.931.0876
17
Item #
Description
1702-A
Arm (S/M/L/XL)
1703-BK
Below Knee (XL/XXL)
1701-TH
Thigh High (S/M/L)
1702-TH
Thigh High (XL)
fax: 616.931.0052
Accessories BiaCare.com
Quality Materials for Long Lasting Value
Donning Loop • Hook and loop attachment for easy donning/doffing • Attaches to any loop surface Item #
Description
1903
Black
Gripper Patch Kit • Rubber traction with hook and loop attachment • For use with CompreBoot,™ CompreBoot™ Plus and MedaBoot ™ Item #
Description
1904
(2) for one boot
Cotton Socks • Seamless, form-fitting design • One size fits small through XX-Large*
Item #
Description
1760-BK
One Pair
1760-BK-3
(3 Pair Pack)
1760-BK-BP
(10 Pair Bulk Pack)
*Refer to CompreBoot™ sizes (pages 41 - 42)
Silver Socks • Antibacterial / antimicrobial • Core-spun for comfort and durability
Description*
One Pair
Case (10 Pair)
1750-BK
1750-BK-C
Small
1751-BK
1751-BK-C
Med/Large
1752-BK
1752-BK-C
X-Large
*Refer to CompreBoot™ sizes (pages 41 - 42)
www.BiaCare.com
18
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Bandages BiaCare.com
Quality Short Stretch 100% Cotton Bandages
BiaFORM™ Premium Short Strech bandage
Single Roll 5051
• Superior stretch and conforming characteristics
• Exceptional durability
Case (20 Rolls) 5051-C
Description 4cm x 5m
5052
5052-C
6cm x 5m
5053
5053-C
8cm x 5m
5054
5054-C
10cm x 5m
5055
5055-C
12cm x 5m
5056
5056-C
10cm x 10m
5057
5057-C
12cm x 10m Made in Germany
ToeFORM™ / FingerFORM™ • ToeFORM™ 2cm x 5m ideal for wrapping edematous toes • FingerFORM™ 3cm x 5m provides superior conforming compression for fingers
Item #
Description
5071
ToeFORM (Bag of 6 rolls)
5072
FingereFORM (Bag of 6 rolls)
IsoFORM™ • 15cm and 20cm widths • Ideal for lymphedema in the thigh or trunk
Single Roll 5061
Case (20 Rolls) 5061-C
Description 15cm x 5m
5062
5062-C
20cm x 5m Made in Mexico
CompreFORM® • Economical short stretch bandages
• Ideal for multi - layer bandaging of extremities
Single Roll 5042
Case (20 Rolls) 5042-C
5043
5043-C
8cm x 5m
5044
5044-C
10cm x 5m
5045
5045-C
12cm x 5m
Description 6cm x 5m
Made in China
ph: 866.931.0876
19
fax: 616.931.0052
Gauze, Padding & Tape BiaCare.com
Clinically Tested to Ensure Superior Performance
ElastoSoft™ Comfortable, soft, elastic bandage • Soft cotton elastic gauze • Ideal for wrapping fingers and toes Single Bag
Case (10 Bags)
Description
5601
5601-C
1” x 4.1 yds (Bag of 24 rolls)
5602
5602-C
2” x 4.1 yds (Bag of 12 rolls)
5603
5603-C
3” x 4.1 yds (Bag of 12 rolls)
5604
5604-C
4” x 4.1 yds (Bag of 12 rolls)
5605
5605-C
6” x 4.1 yds (Bag of 6 rolls) Made in Mexico
Non-Woven Padding • Soft synthetic padding • Ideal for use under short stretch bandages Item #
Single Roll
Item #
Case
5661
10cm x 3.5m (4” x 3.8 yds)
5661-C
Case of 30
5662
15cm x 3.5m (6” x 3.8 yds)
5662-C
Case of 20
BiaSoft™ • Soft yet durable rolled fleece padding for use under short stretch bandages
• Can be machine washed
Single Roll
and dried for repeated use
Description
5251
6cm x 3m
5252
10cm x 3m
5253
15cm x 3m
3M DuraPore™ Silk Surgical Tape
Item #
• Exceptionally durable,
5691
1” x 10yds
5691-B
1” x 10yds (Box of 12)
5691-C
1” x 10yds (Case of 10 boxes)
5692
2” x 10yds
5692-B
2” x 10yds (Box of 6)
5692-C
2” x 10yds (Case of 10 boxes)
easy to cut to size
• Ideal for securing bandages
www.BiaCare.com
Description
20
[email protected]
Foam BiaCare.com
Open Cell Foam for Treatment of Lymphedema • All foam sheets can be easily cut to desired shape
LympheSoft® Soft, open-cell foam • Provides even compression distribution when bandaging • Ideal for use with BiaForm™ or CompreForm® short-stretch bandages • Air permeable Single Roll Case of 12 Description 5101 5101-C 10cm x 2.5m • Tear resistant Hand wash / air dry
NEW
larger size
larger size
5102-C
12cm x 2.5m
5103
5103-C
15cm x 2.5m
WaveFoam™ • High-pressure ridges gently massage thickened, fibrotic areas • Low-pressure channels allow pathways for fluid evacuation • Flat on one side Hand wash / air dry
NEW
5102
Item #
Description
5202
1.2cm x 69cm x 90cm
WaveFoam™ II • High-pressure ridges gently massage thickened, fibrotic areas • Low-pressure channels allow pathways for fluid evacuation • Waves on both sides Hand wash / air dry
Item #
Description
5212
1.2cm x 69cm x 90cm
GrayFoam • Moderately rigid open-cell foam • Helps soften fibrotic areas • Provides firm, stable support under BiaForm™ or CompreForm® short-stretch bandages Hand wash / air dry
ph: 866.931.0876
21
Item #
Description
5301
1/4” x 18” x 72”
5302
1/2” x 18” x 72”
fax: 616.931.0052
Stockinette & Dressing Retainer BiaCare.com
Cotton Tubular Stockinette • 100% Cotton • Non-compressive liner for nighttime bandaging or compression garments
• Available in a range of sizes to fit almost any application
Single Roll
Description
5402
2” x 25 yds
5403
3” x 25 yds
5404
4” x 25 yds
5405
5” x 25 yds
5406
6” x 25 yds
5408
8” x 25 yds Made in USA / Mexico
BiaGrip™ • Compressive cotton stockinette • Can be washed and reused for an economical compression alternative
• Cut to size
Single Roll 5430
Description Size A (11/2” x 11 yds)
5431
Size B (21/2” x 11 yds)
5432
Size C (33/4” x 11 yds)
5433
Size D (3” x 11 yds)
5434
Size E (31/2” x 11 yds)
5435
Size F (4” x 11 yds)
5436
Size G (5” x 11 yds)
5437
Size J (7” x 11 yds)
5438
Size K (8” x 11 yds)
5439
Size L (12” x 11 yds)
BiaNet™ Tubular Dressing Retainer • Soft mesh liner stretches to secure wound dressings • Ideal for securing short stretch bandages • 25 yds stretched Single Roll Description Hand wash / air dry
5261
Size 1 - Finger
5263
Size 3 - Medium: hand, arm, leg, foot
5266
Size 6 - Large: head, shoulder, thigh
5267
Size 7 - Small: chest, back, perineum Made in Mexico
www.BiaCare.com
22
[email protected]
Rev. 11/11
FoamSleeve,™ ChipSleeve,™ CompreSleeve,™ OverSleeve™- ARM Measuring Form PO#:
Contact Name:
Company:
Phone:
Bill-To Address:
Ship-To Address: Patient:
Sex:
Age:
q q
Ht:
Wt:
Arm
Product
q q
Date:
q
FoamSleeve™ - ARM ChipSleeve™ - ARM (Includes OverSleeve™) Specify Color: ____________
Right
q
(All measurments in cm)
C
CompreSleeve™ - ARM OverSleeve™ - Arm Only Specify Color:____________
Left
Circumference at Axilla
B1
Circumference at mid Bicep
Measuring Instructions
D
Standard UE (Upper Extremity)
1. Place the arm extended and relaxed slightly with the palm down on a flat surface. 2. Measure point A circumference at wrist. (All measurments in cm) 3. Measure point B circumference at elbow. 4. Measure point B1 circumference at mid bicep 5. Measure point C at axilla. 6. Measure D length at dorsal aspect from point A wrist to point C axilla.
ph: 866.931.0876
23
B
Circumference at Elbow
A
Circumference at Wrist
fax: 616.931.0052
FoamSleeve,™ ChipSleeve,™ CompreSleeve,™ and OverSleeve™- Arm Sizing Chart C B1 B A D
Small
Medium
Large
X-Large
23 - 32
28 - 37
33 - 43
39 - 49
21.5 - 29.5
26 - 34
30.5 - 39
35 - 44
20 - 27
24 - 30.5
28 -35
32 - 39
14 - 16.5
15 - 18
16.5 - 19
18 - 20
Short: 38 - 43
Regular: 43 - 48
Long: > 48
FoamSleeve™- ARM Item Numbers LEFT
RIGHT
SIZES
Short
Regular
Long
Short
Regular
Long
Small
1603-AS-L
1603-AR-L
1603-AL-L
1603-AS-R
1603-AR-R
1603-AL-R
Medium
1605-AS-L
1605-AR-L
1605-AL-L
1605-AS-R
1605-AR-R
1605-AL-R
Large
1607-AS-L
1607-AR-L
1607-AL-L
1607-AS-R
1607-AR-R
1607-AL-R
XL
1609-AS-L
1609-AR-L
1609-AL-L
1609-AS-R
1609-AR-R
1609-AL-R
ChipSleeve™ - ARM Item Numbers LEFT
RIGHT
SIZES
Short
Regular
Long
Short
Regular
Long
Small
2631-AS-L
2631-AR-L
2631-AL-L
2631-AS-R
2631-AR-R
2631-AL-R
Medium
2632-AS-L
2632-AR-L
2632-AL-L
2632-AS-R
2632-AR-R
2632-AL-R
Large
2633-AS-L
2633-AR-L
2633-AL-L
2633-AS-R
2633-AR-R
2633-AL-R
XL
2634-AS-L
2634-AR-L
2634-AL-L
2634-AS-R
2634-AR-R
2634-AL-R
XXL
2635-AS-L
2635-AR-L
2635-AL-L
2635-AS-R
2635-AR-R
2635-AL-R
Custom
2639-A
CompreSleeve™ - ARM Item Numbers LEFT
RIGHT
SIZES
Short
Regular
Long
Short
Regular
Long
Small
1501-SHO-L
1501-REG-L
1501-LNG-L
1501-SHO-R
1501-REG-R
1501-LNG-R
Medium
1502-SHO-L
1502-REG-L
1502-LNG-L
1502-SHO-R
1502-REG-R
1502-LNG-R
Large
1503-SHO-L
1503-REG-L
1503-LNG-L
1503-SHO-R
1503-REG-R
1503-LNG-R
XL
1504-SHO-L
1504-REG-L
1504-LNG-L
1504-SHO-R
1504-REG-R
1504-LNG-R
OverSleeve™ - ARM Item Numbers BLACK
NAVY
PINK
LEOPARD
TIE DYE
SIZES
Short
Reg / Long
Short
Reg / Long
Short
Reg / Long
Short
Reg / Long
Short
Reg / Long
Small
1801-AS
1801-A
1821-AS
1821-A
1841-AS
1841-A
1851-AS
1851-A
1861-AS
1861-A
Medium
1802-AS
1802-A
1822-AS
1822-A
1842-AS
1842-A
1852-AS
1852-A
1862-AS
1862-A
Large/XL
1803-AS
1803-A
1823-AS
1823-A
1843-AS
1843-A
1853-AS
1853-A
1863-AS
1863-A
Custom
www.BiaCare.com
1809-A
24
[email protected]
Rev. 11/11
FoamSleeve,™ ChipSleeve,™ OverSleeve™ - BK Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
Product
q q q
Age:
Date:
Ht:
Wt:
FoamSleeve™ - BK ChipSleeve™ - BK (Includes OverSleeve™) Specify Color: ____________ OverSleeve™ - BK Only Specify color____________ = Length measurments taken on lateral aspect
(All measurments in cm)
C i rc u m fe re n c e
Below Knee (BK)
Right
Left
C1 C
30cm 25cm
B A
Bottom of Patella
G Length
15cm 5cm
Lateral Malleolus (Outer Ankle Bone) (ø Point)
Measuring Instructions 1
2.
ph: 866.931.0876
Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Bottom of Patella record in the corresponding box G. (All measurments in cm) Measure circumferences where indicated by the black dots from the lateral malleolus (Outer Ankle Bone) and record in the corresponding lines A, B, C, C1.
25
fax: 616.931.0052
FoamSleeve,™ ChipSleeve,™ OverSleeve,™- BK Sizing Chart C1
30cm
Small 32 - 42
Medium 37 - 47
Large 42 - 52
C B A G
25cm 15cm 5cm
29 - 39 24 - 34 20 - 29
34 - 44 29 - 39 21 - 30
39 - 49 33 - 43 25 - 36
Regular: 28 - 36
Tall: > 36
Measuring Point
X-Large
XX-Large
51 - 61 48 - 58 41 - 51 32 - 42
58 - 68 55 - 65 44 - 55 33 - 43
FoamSleeve™ - BK Item Numbers SIZES
Regular
Tall
Small
1601-BKR
1601-BKT
Medium
1602-BKR
1602-BKT
Large
1603-BKR
1603-BKT
X-Large
1604-BKR
1604-BKT
XX-Large
1605-BKR
1605-BKT
ChipSleeve™ - BK Item Numbers SIZES
Regular
Tall
Small
2631-BKR
2631-BKT
Medium
2632-BKR
2632-BKT
Large
2633-BKR
2633-BKT
X-Large
2634-BKR
2634-BKT
XX-Large
2635-BKR
2635-BKT
Custom
2639-BK
OverSleeve™ - BK Item Numbers BLACK
NAVY
PINK
LEOPARD
TIE DYE
SIZES
Regular / Tall
Regular / Tall
Regular / Tall
Regular / Tall
Regular / Tall
Small
1801-BK
1821-BK
1841-BK
1851-BK
1861-BK
Medium
1802-BK
1822-BK
1842-BK
1852-BK
1862-BK
Large
1803-BK
1823-BK
1843-BK
1853-BK
1863-BK
XL/XXL
1804-BK
1824-BK
1844-BK
1854-BK
1864-BK
Custom
www.BiaCare.com
1809-BK
26
[email protected]
Rev. 11/11
ChipSleeve,™ OverSleeve™- TH Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
Product
q q
Age:
Date:
Ht:
Wt:
ChipSleeve™ - TH (Includes OverSleeve™) Specify Color: ____________ OverSleeve™ - TH Only Specify Color:____________ C i rc u m fe re n c e
Right
F E D
Left
Gluteal Fold
23cm
(All measurments in cm)
15cm
= Length measurments taken on lateral aspect
5cm
Top of Patella (ø Point)
= Length measurments taken on lateral aspect
C1 C
Bottom of Patella
H Length
30cm 25cm
B
15cm
A
5cm Lateral Malleolus (ø Point) (Outer Ankle Bone)
Measuring Instructions 1. Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Gluteal Fold and record in the corresponding box H. (All measurments in cm) 2. Measure circumferences where indicated by the black dots from the lateral malleolus (outer ankle bone) and record in the corresponding lines A, B, C, C1. Measure from the lateral aspect Top of Patella and record in the corresponding lines D, E, F (Right/Left). ph: 866.931.0876
27
fax: 616.931.0052
ChipSleeve,™ OverSleeve™- TH Sizing Chart Small
Medium
Large
X-Large
F
48 - 58
56 - 66
64 - 74
74 - 84
E D
43 - 53 38 - 48
51 - 61 46 - 56
58 - 68 53 - 63
68 - 78 63 - 73
C1 C B A H
32 - 42 29 - 39 24 - 34 20 - 29
37 - 47 34 - 44 29 - 39 21 - 30
42 - 52 39 - 49 33 - 43 25 - 36
51 - 61 48 - 58 41 - 51 32 - 42
Short: 61 - 71
Regular: 71 - 81
Tall: 81 - 91
ChipSleeve™ - TH Item Numbers LEFT
RIGHT
SIZES
Short
Regular
Tall
Short
Regular
Tall
Small
2631-THS-L
2631-THR-L
2631-THT-L
2631-THS-R
2631-THR-R
2631-THT-R
Medium
2632-THS-L
2632-THR-L
2632-THT-L
2632-THS-R
2632-THR-R
2632-THT-R
Large
2633-THS-L
2633-THR-L
2633-THT-L
2633-THS-R
2633-THR-R
2633-THT-R
X-Large
2634-THS-L
2634-THR-L
2634-THT-L
2634-THS-R
2634-THR-R
2634-THT-R
XX-Large
2635-THS-L
2635-THR-L
2635-THT-L
2635-THS-R
2635-THR-R
2635-THT-R
Custom
2639-TH
OverSleeve™ - TH Item Numbers SIZES
BLACK Short Reg / Tall
Short
NAVY Reg / Tall
Short
PINK Reg / Tall
LEOPARD Short Reg / Tall
TIE DYE Short Reg / Tall
Small 1801-THS
1801-TH
1821-THS
1821-TH
1841-THS
1841-TH
1851-THS
1851-TH
1861-THS
1861-TH
Medium 1802-THS
1802-TH
1822-THS
1822-TH
1842-THS
1842-TH
1852-THS
1852-TH
1862-THS
1862-TH
L/XL 1803-THS
1803-TH
1823-THS
1823-TH
1843-THS
1843-TH
1853-THS
1853-TH
1863-THS
1863-TH
Custom
www.BiaCare.com
1809-TH
28
[email protected]
Rev. 11/11
CompreFit,® CompreFit® PLUS, CompreFit® Foam Liner - BK Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
Product
q q q
Age:
Ht:
Wt:
CompreFit® color
q q
CompreFit® - BK (Compreboot™ included) CompreFit® PLUS - BK (Compreboot™ included)
q
Date:
Black Beige
With CompreBoot™ PLUS (Additional charges apply)
CompreFit® - BK Foamliner Only C i rc u m fe re n c e
Right
C1 C
= Length measurments taken on lateral aspect
Bottom of Patella
Left
(All measurments in cm)
30cm 25cm
G Length
B
15cm
A
5cm
I
R
L
I J K
Lateral Malleolus (ø Point) (Outer Ankle Bone) Circumference of Ankle Bend and Heel
Foot Measurments
(Sizing Chart p. 41)
J
K
Circumference across Metatarsal Heads
1st Metatarsal Head to Heel (or desired length)
Measuring Instructions 1. 2. 3.
Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Bottom of Patella and record in the corresponding box G. Measure circumferences where indicated by the black dots from the lateral malleolus (Outer Ankle Bone) and record in the corresponding lines A, B, C, C1 (Right/Left). Measure foot circumferences and length and record on lines I, J, K.
ph: 866.931.0876
29
fax: 616.931.0052
CompreFit®- BK Sizing Chart C1
Small
Medium
Large
X-Large
XX-Large
29 - 39
34 - 44
39 - 49
48 - 58
55 - 65
C
29 - 39
34 - 44
39 - 49
48 - 58
55 - 65
B
24 - 34
29 - 39
33 - 43
41 - 51
44 - 55
A
20 - 29
21 - 30
32 - 42
33 - 43
25 - 36 Regular: 30 - 36
G
Tall: > 36
CompreFit®- BK Tall Sizing Chart (G > 36cm) Small Tall
Medium Tall
Large Tall
X-Large Tall
XX-Large Tall
C1
29 - 39
34 - 44
39 - 49
48 - 58
55 - 65
C
26 - 36
31 - 41
35 - 45
44 - 54
50 - 60
B
21 - 31
25 - 35
30 - 40
36 - 46
40 - 50
A
20 - 29
21 - 30
25 - 36
32 - 42
33 - 43
Regular: 30 - 36
G
Tall: > 36
CompreFit® - BK Item Numbers REGULAR
TALL
SIZES
BLACK
BEIGE
BLACK
BEIGE
Small
1101-BKR
1111-BKR
1101-BKT
1111-BKT
Medium Large
1102-BKR 1103-BKR
1112-BKR 1113-BKR
1102-BKT 1103-BKT
1112-BKT 1113-BKT
X-Large
1104-BKR
1114-BKR
1104-BKT
1114-BKT
XX-Large
1105-BKR
1115-BKR
1105-BKT
1115-BKT
CompreFit® PLUS, CompreFit® Foamliner - BK Sizing Chart Small
Medium
Large
X-Large
C1
24 - 34
29 - 39
34 - 44
43 - 53
XX-Large 50 - 60
C
24 - 34
29 - 39
34 - 44
43 - 53
50 - 60
B
19 - 29
24 - 34
28 - 38
36 - 46
39 - 50
A
15 - 24
16 - 25
20 - 31
27 - 37
28 - 38
Regular: 30 - 36
G
Tall: > 36
CompreFit® PLUS, CompreFit® Foamliner - BK Tall Sizing Chart (G > 36cm) Small Tall
Med Tall
Large Tall
X-Large Tall
XX-Large Tall
C1
24 - 34
29 - 39
34 - 44
43 - 53
50 - 60
C
21 - 31
26 - 36
30 - 40
39 - 49
45 - 55
B
16 - 26
20 - 30
25 - 35
31 - 41
35 - 45
A
15 - 24
16 - 25
27 - 37
28 - 38
20 - 31 Regular: 30 - 36
G
Tall: > 36
CompreFit® PLUS - BK Item Numbers SIZES Small Medium Large X-Large XX-Large
www.BiaCare.com
REGULAR Black Beige 1151-BKR 1161-BKR 1152-BKR 1162-BKR 1153-BKR 1163-BKR 1154-BKR 1164-BKR 1155-BKR 1165-BKR
CompreFit®- BK FoamLiner Item Numbers
TALL Black 1151-BKT 1152-BKT 1153-BKT 1154-BKT 1155-BKT
Beige 1161-BKT 1162-BKT 1163-BKT 1164-BKT 1165-BKT
30
FOAMLINER ONLY SIZES Regular Tall Small 1101-BKRL 1111-BKTL Medium 1102-BKRL 1112-BKTL Large 1103-BKRL 1113-BKTL X-Large 1104-BKRL 1114-BKTL XX-Large 1105-BKRL 1115-BKTL NOTE: FoamLiner included in CompreFit® PLUS.
[email protected]
Rev. 11/11
CompreFit® TC/BK Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
q q q
Date:
Age:
CompreFit® - TC Thigh Component (CompreKnee™ included) CompreKnee™ - Only CompreFit® - BK (CompreBoot™ included)
Ht:
Wt:
CompreFit® color
q q
Black Beige
C i rc u m fe re n c e
F E D
Left 23cm 15cm 5cm
Top of Patella (ø Point)
= Length measurments taken on lateral aspect
Bottom of Patella
(All measurments in cm)
Below Knee (BK)
Thigh Component (TC)
Right
C1 C
30cm 25cm
G Length
B A
1. 2. 3.
J
5cm
Measuring Instructions
K
K
J
Circumference across Metatarsal Heads
(Sizing Chart p. 41)
1st Metatarsal Head to Heel (or desired length)
BK - Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Bottom of Patella and record in the corresponding box G. Measure circumferences where indicated by the black dots; BK from the lateral malleolus (Outer Ankle Bone) and record in the corresponding lines A, B, C, C1; TC from the lateral aspect Top of Patella and record in the corresponding lines D, E, F (Right/Left). Measure foot circumferences and length and record on lines I, J, K.
ph: 866.931.0876
L
I
Lateral Malleolus (Outer Ankle Bone) (ø Point)
I
R
(BK Only)
15cm
Circumference of Ankle Bend and Heel
Foot Measurments
31
fax: 616.931.0052
CompreFit® - TC Sizing Chart Small
Medium
Large
X-Large
F
48 - 58
56 - 66
64 - 74
74 - 84
E
43 - 53
51 - 61
58 - 68
68 - 78
D
38 - 48
46 - 56
53 - 63
63 - 73
XX-Large n/a
CompreFit® - TC Item Numbers REGULAR / TALL* SIZES
Black
Beige
Small
1101-TC
1111-TC
Medium
1102-TC
1112-TC
Large
1103-TC
1113-TC
X-Large
1104-TC
1114-TC *Adjustable length
CompreFit® - BK Sizing Chart C1
Small
Medium
Large
X-Large
XX-Large
30 - 40
35 - 45
40 - 50
48 - 58
55 - 65
C
29 - 39
34 - 44
39 - 49
48 - 58
55 - 65
B
24 - 34
29 - 39
33 - 43
41 - 51
44 - 55
A
20 - 29
21 - 30
32 - 42
33 - 43
25 - 36 Regular: 30 - 36
G
Tall: > 36
CompreFit® - BK Tall Sizing Chart (G > 36cm) Small Tall
Medium Tall
Large Tall
X-Large Tall
XX-Large Tall
C1
29 - 39
34 - 44
39 - 49
48 - 58
55 - 65
C
26 - 36
31 - 41
35 - 45
44 - 54
50 - 60
B
21 - 31
25 - 35
30 - 40
36 - 46
40 - 50
A
20 - 29
21 - 30
25 - 36
32 - 42
33 - 43
Regular: 30 - 36
G
Tall: > 36
CompreFit® - BK Item Numbers REGULAR
TALL
SIZES
Black
Beige
Regular
Beige
Small
1101-BKR
1111-BKR
1101-BKT
1111-BKT
Medium
1102-BKR
1112-BKR
1102-BKT
1112-BKT
Large
1103-BKR
1113-BKR
1103-BKT
1113-BKT
X-Large
1104-BKR
1114-BKR
1104-BKT
1114-BKT
XX-Large
1105-BKR
1115-BKR
1105-BKT
1115-BKT
CompreKnee™ Item Numbers
CompreKnee™ Sizing Chart Small
Medium
Large / X-Large
SIZES
Black
Beige
D C1
38 - 48 29 - 39
46 - 56 34 - 44
53 - 73
Small
1101-KP
1111-KP
39 - 65
Medium
1102-KP
1112-KP
C
29 - 39
34 - 44
39 - 65
Large/XL
1103-KP
1113-KP
NOTE: FoamLiner included in CompreFit PLUS.
www.BiaCare.com
32
[email protected]
Rev. 11/11
CompreFlex™ - BK/TC Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
q q
Age:
CompreFlex™ - BK (CompreBoot™ included) CompreFlex™ - TC Thigh Component (CompreKnee™ included)
Date:
Ht:
Wt:
C i rc u m fe re n c e
F E D
Left Gluteal Fold
23cm (TC Only)
5cm
Top of Patella (ø Point)
C1 C
(All measurments in cm)
25cm
G Length
B A
= Length measurments taken on lateral aspect
30cm
L
J
5cm
Measuring Instructions
R
I
Lateral Malleolus (Outer Ankle Bone) (ø Point)
I
Foot Measurments
(BK Only)
15cm
Circumference of Ankle Bend and Heel
1. 1.a 2. 3.
G1 Length
15cm
Bottom of Patella
Below Knee (BK)
Thigh Component (TC)
Right
K
K
J
(Sizing Chart p. 41) Circumference across Metatarsal Heads
1st Metatarsal Head to Heel (or desired length)
BK - Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Bottom of Patella and record in the corresponding box G. TC - Measure length from the lateral aspect top of Patella to lateral aspect Gluteal fold and record in the corresponding box G1. Measure circumferences where indicated by the black dots; BK from the lateral malleolus (Outer Ankle Bone) and record in the corresponding lines A, B, C, C1; TC from the lateral aspect Top of Patella and record in the corresponding lines D, E, F. (Right/Left). Measure foot circumferences and length and record on lines I, J, K.
ph: 866.931.0876
33
fax: 616.931.0052
CompreFlex™ - TC Sizing Chart Small
Medium
Large
X-Large
F
48 - 58
56 - 66
64 - 74
74 - 84
E
43 - 53
51 - 61
58 - 68
68 - 78
D
38 - 48
46 - 56
53 - 63 Regular: 20 - 25
G1
XX-Large n/a
63 - 73 Tall: 25 - 30
CompreFlex™ - TC Item Numbers LEFT
RIGHT
SIZES
Regular
Tall
Regular
Tall
Small
1401-TCR-L
1401-TCT-L
1401-TCR-R
1401-TCT-R
Medium
1402-TCR-L
1402-TCT-L
1402-TCR-R
1402-TCT-R
Large
1403-TCR-L
1403-TCT-L
1403-TCR-R
1403-TCT-R
X-Large
1404-TCR-L
1404-TCT-L
1404-TCR-R
1404-TCT-R
XX-Large
1405-TCR-L
1405-TCT-L
1405-TCR-R
1405-TCT-R
CompreFlex™ - BK Sizing Chart Small
Medium
Large
X-Large
XX-Large
C1
29 - 39
34 - 44
40 - 50
46 - 56
54 - 64
C
29 - 39
34 - 44
40 - 50
46 - 56
54 - 64
B
24 - 34
29 - 39
34 - 44
39 - 49
44 - 55
A
16 - 26
21 - 30
26 - 36
31 - 41
36 - 46
Regular: 30 - 36
G
Tall: > 36
CompreFlex™- BK Item Numbers BLACK SIZES
Regular
Tall
Small
1401-BKR
1401-BKT
Medium
1402-BKR
1402-BKT
Large
1403-BKR
1403-BKT
X-Large
1404-BKR
1404-BKT
XX-Large
1405-BKR
1405-BKT
Custom
1409-BKC
1409-BKC
CompreKnee™ Sizing Chart Small
Medium
Large / X-Large
D C1
38 - 48 29 - 39
46 - 56 34 - 44
53 - 73
C
29 - 39
34 - 44
39 - 65
39 - 65
CompreKnee™ Item Numbers
www.BiaCare.com
SIZES
Black
Small
1101-KP
Medium
1102-KP
Large/XL
1103-KP
34
[email protected]
Rev. 11/11
CompreShorts™ / GeniFit™ Pad Measuring Form
PO#:
Contact Name:
Company:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
CompreShorts™
Date:
Age:
Ht:
Wt:
GeniFit™ Pad Dimensions
(All measurments in cm)
Waist
Width (cm) Rise (cm)
Hip
Length (cm) (Female shown)
Mid Thigh
GeniFit™ Pad
Female
GeniFit™ Pad
Male
(All measurments in cm)
(All measurments in cm)
Width
Width
Width
Width Rise
Rise
Rise
Rise Scrotal Circumference
ph: 866.931.0876
35
fax: 616.931.0052
CompreShorts™ Item Numbers / Sizing SIZES
Item#
Waist
Hip
Mid Thigh
Small
1301
69-76
84-91
41-61
1301-MAX
76-86
91-102
41-61
1302
76-86
91-102
46-53
1302-MAX
86-97
102-112
46-53
1303
86-97
102-112
53-61
1303-MAX
97-112
112-127
53-61
1304
97-112
112-127
61-71
1304-MAX
112-132
127-147
61-71
1305
112-132
127-147
71-81
1305-MAX
132-152
147-168
71-81
1306
132-152
147-168
81-91
1306-MAX
152-172
168-188
81-91
1307
152-172
168188
91-101
Small Max Medium Medium Max Large Large Max X-Large X-Large Max 2X-Large 2X-Large Max 3X-Large 3X-Large Max 4X-Large 4X-Large Max
1307-Max
172-193
188-208
91-101
5X-Large
1308
172-193
188-208
101-112
Custom
1309
GeniFit™ Pad - Female Low-Cut Item Numbers / Sizing SIZES
Item#
Width
Rise
Length
Small
1301-FLC
28
14
30
Medium
1302-FLC
32
16
33
Large
1303-FLC
36
18
36
X-Large
1304-FLC
40
20
39
GeniFit™ Pad - Female High-Cut Item Numbers / Sizing SIZES
Item#
Width
Rise
Length
Small
1301-FHC
28
22
57
Medium
1302-FHC
32
35
60
Large
1303-FHC
36
38
63
X-Large
1304-FHC
40
41
66
GeniFit™ Pad - Male Low-Cut Item Numbers / Sizing SIZES
Item#
Width
Rise
Length
Small
1301-MLC
28
14
28
26
Medium Large
1302-MLC 1303-MLC
32 36
16 18
31 34
32 38
Scrotal circ.
X-Large
1304-MLC
40
20
37
44
XX-Large
1304-MLC
44
22
40
51
GeniFit™ Pad - Male High-Cut Item Numbers / Sizing
www.BiaCare.com
SIZES
Item#
Width
Rise
Length
Small
1301-MHC
28
32
45
26
Medium Large
1302-MHC 1303-MHC
32 36
35 38
48 51
32 38
Scrotal circ.
X-Large
1304-MHC
40
41
54
44
XX-Large
1304-MHC
44
44
57
51
36
[email protected]
Rev. 11/11
MedaFit™- ARM Measuring Form PO#:
Contact Name:
Company:
Phone:
Bill-To Address:
Ship-To Address: Patient:
Sex:
Age:
Ht:
Wt:
Arm
Product
q
Date:
q
MedaFit™ - ARM
Right
q
Left
(MedaHand included)
q q q q q
(All measurments in cm)
MedaGlove Upgrade (additional cost)
C
MedaHand™ (ONLY)
Circumference of Axilla
MedaGlove™ (ONLY)
B1
Hand OverSleeve™ (Black)
Circumference at mid Bicep
Glove OverSleeve™ (Black)
D
B
Circumference of Elbow
Measuring Instructions
Standard UE (Upper Extremity) 1. Place the arm extended and relaxed slightly with the palm down on a flat surface. 2. Measure point A circumference at wrist. (All measurments in cm) 3. Measure point B circumference at elbow. 4. Measure point B1 circumference at mid bicep 5. Measure point C at axilla. 6. Measure D length at dorsal aspect from point A wrist to point C axilla. 7. Measure circumference of palm E.
ph: 866.931.0876
37
A
Circumference of Wrist Circumference of Palm
E
fax: 616.931.0052
MedaFit™ - ARM Sizing Chart C B1 B A D
Small
Medium
Large
X-Large
23 - 32
28 - 37
33 - 43
39 - 49
21.5 - 29.5
26 - 34
30.5 - 39
35 - 44
20 - 27
24 - 30.5
28 -35
32 - 39
14 - 16.5
15 - 18
16.5 - 19
18 - 20
Short: 38 - 43
Regular: 43 - 48
Long: > 48
MedaFit™ - ARM Item Numbers LEFT
RIGHT
SIZES
Short
Regular
Long
Short
Regular
Long
Small
1201-AS-L
1201-AR-L
1201-AL-L
1201-AS-R
1201-AR-R
1201-AL-R
Medium
1202-AS-L
1202-AR-L
1202-AL-L
1202-AS-R
1202-AR-R
1202-AL-R
Large
1203-AS-L
1203-AR-L
1203-AL-L
1203-AS-R
1203-AR-R
1203-AL-R
X-Large
1204-AS-L
1204-AR-L
1204-AL-L
1204-AS-R
1204-AR-R
1204-AL-R
Hand / Glove Sizing Chart Size
Palm (E)
Wrist (A)
Small
15 - 19
13.5 - 19.5
Medium
19 - 22
15.5 - 21.5
Large
22 - 26
17.5 - 23.5
XL
26 - 29
20 - 26
MedaHand™ Item Numbers SIZES
Left
Right
SIZES
Left
Right
Small
1201-H-L
1201-H-R
Small
1201-G-L
1201-G-R
Medium
1202-H-L
1202-H-R
Medium
1202-G-L
1202-G-R
Large
1203-H-L
1203-H-R
Large
1203-G-L
1203-G-R
XL
1204-H-L
1204-H-R
XL
1204-G-L
1204-G-R
Hand OverSleeve™ Items SIZES
www.BiaCare.com
MedaGlove™ Item Numbers
Left
Glove OverSleeve™ Items
Right
SIZES
Left
Right
Small
1801-H-L
1801-H-R
Small
1801-G-L
1801-G-R
Medium
1802-H-L
1802-H-R
Medium
1802-G-L
1802-G-R
Large
1803-H-L
1803-H-R
Large
1803-G-L
1803-G-R
XL
1804-H-L
1804-H-R
XL
1804-G-L
1804-G-R
38
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Rev. 11/11
CompreSleeve,™ MedaFit™- BK Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
Product
Age:
Date:
Ht:
Wt:
q CompreSleeve™ - BK (CompreBoot™ included) q MedaFit™ - BK (CompreBoot™ Plus included)
C i rc u m fe re n c e
Right
C1 C
= Length measurments taken on lateral aspect
Bottom of Patella
Left
(All measurments in cm)
30cm 25cm
G Length
B
15cm
A
5cm
I
R
L
I J K
Lateral Malleolus (ø Point) (Outer Ankle Bone) Circumference of Ankle Bend and Heel
Foot Measurments
(Sizing Chart p. 41) across J Circumference Metatarsal Heads
K 1st Metatarsal Head to Heel (or desired boot length)
Measuring Instructions 1. 2. 3.
Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Bottom of Patella and record in the corresponding box G. Measure circumferences where indicated by the black dots from the lateral malleolus (outer ankle bone) and record in the corresponding lines A, B, C, C1 (Right/Left). Measure foot circumferences and length and record on lines I, J, K.
ph: 866.931.0876
39
fax: 616.931.0052
CompreSleeve,™ MedaFit™ - BK Sizing Chart C1 C B A G
Small
Medium
Large
X-Large
XX-Large
32 - 42
38 - 48
42 - 52
51 - 61
58 - 68
29 - 39
34 - 44
39 - 49
48 - 58
55 - 65
24 - 34
29 - 39
33 - 43
41 - 51
44 - 55
20 - 29
21 - 30
25 - 36
32 - 42
33 - 43
Short : 25 - 30
Regular: 30 - 36
Tall: > 36
CompreSleeve™ - BK Item Numbers SIZES
Short
Regular
Tall
Small
1501-BKS
1501-BKR
1501-BKT
Medium
1502-BKS
1502-BKR
1502-BKT
Large
1503-BKS
1503-BKR
1503-BKT
X-Large
1504-BKS
1504-BKR
1504-BKT
XX-Large
1505-BKS
1505-BKR
1505-BKT
MedaFit™ - BK Item Numbers
www.BiaCare.com
SIZES
Short
Regular
Tall
Small
1201-BKS
1201-BKR
1201-BKT
Medium
1202-BKS
1202-BKR
1202-BKT
Large
1203-BKS
1203-BKR
1203-BKT
X-Large
1204-BKS
1204-BKR
1204-BKT
XX-Large
1205-BKS
1205-BKR
1205-BKT
40
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Rev. 11/11
CompreBoot,™ CompreBoot™ PLUS, MedaBoot,™ Ankle Pad Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
Product
q q q q
Date:
Age:
Ht:
CompreBoot™ CompreBoot™ PLUS MedaBoot™- CUSTOM Ankle Pad (All measurments in cm)
Length
Right
L
Left
K
Circumference at Ankle Bend
I
M
M
(MedaBoot™ only)
Circumference
Right
Circumference at Ankle Bend and Heel
Top of foot: 3rd Metatarsal Head to Ankle Bend
(MedaBoot™ only)
Left
I J L
ph: 866.931.0876
K 1st Metatarsal Head to Heel (or desired boot length)
41
J
Circumference across Metatarsal Heads
fax: 616.931.0052
Measuring Instructions
CompreBoot™ / CompreBoot™ PLUS 1.
Record length measurement K (length from 1st metatarsal head to heel or desired length) on the corresponding line. Select the boot size that matches according to row K on the Sizing Chart below.
2.
Record circumference measurements I, J, and L on the corresponding lines.
4.
If any of the above foot measurements (I, J, and L ) exceed the adjustment range of the boot size selected in STEP 1 (K) above, select the next larger size where all three measurements do not exceed the adjustment range of the boot.
3.
Check to make certain that foot measurements I, J, and L do not exceed the adjustment range for the boot size selected in STEP 1 (measurment K - Sizing Chart row K).
CompreBoot,™ CompreBoot™ PLUS, Ankle Pad Sizing Chart K
Small
Small - Long
Med/Large
Med/Large - Long
XL-XXL
XL-XXL - Long
14 - 18
19 - 23
18 - 20
23 - 25
20 - 22
25 - 27
I
28 - 36
28 - 36
39 max
39 max
44 max
44 max
J
22 - 26
22 - 26
30 max
30 max
33 max
33 max
L
25 - 30
25 - 30
36 max
36 max
43 max
43 max
CompreBoot™ PLUS Item Numbers
CompreBoot™ Item Numbers BLACK
BLACK
BEIGE
SIZES
Regular
Long
Regular
Long
SIZES
Regular
Long
Small
1101-F-REG
1101-F-LNG
1111-F-REG
1111-F-LNG
Small
1101-FP-REG
1101-FP-LNG
Med/Large
1102-F-REG
1102-F-LNG
1112-F-REG
1112-F-LNG
Med/Large
1102-FP-REG
1102-FP-LNG
XL/XXL
1103-F-REG
1103-F-LNG
1113-F-REG
1113-F-LNG
XL/XXL
1103-FP-REG
1103-FP-LNG
CompreBoot™ PLUS Foam Liner Items
Ankle Pad Item Number
SIZES
Regular
Long
SIZES
Item#
Small
1101-FP-RL
1101-FP-LL
Small / Med / Large
1102-AP
Med/Large
1102-FP-RL
1102-FP-LL
X-Large / XX-Large
1103-AP
XL/XXL
1103-FP-RL
1103-FP-LL
Measuring Instructions MedaBoot™
*Digital photos are required when irregular shapes are present
1. Record length measurement K (length from 1st metatarsal head to heel or desired length) on the corresponding line.
2. Record length measurement M (Top of Foot/3rd Metatarsal Head to Ankle Bend) on the corresponding line. 3. Record circumference measurements I, J, and L on the corresponding lines.
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42
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Rev. 11/11
CompreSleeve,™ MedaFit™-TH Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address:
Sex:
Patient:
Product
q
q
CompreSleeve™ - TH
Age:
Date:
Ht:
Wt:
MedaFit™ - TH
C i rc u m fe re n c e
Right
Left
F E D
Gluteal Fold
23cm
(All measurments in cm)
15cm
= Length measurments taken on lateral aspect
5cm
Top of Patella
= Length measurments taken on lateral aspect
ø Point)
(
H Length
Bottom of Patella
C1 C
30cm
Foot Measurments R
25cm
L
I
B
15cm
A
5cm
J K (Sizing Chart p. 41)
Lateral Malleolus (ø Point) (Outer Ankle Bone) Circumference of Ankle Bend and Heel
I
K
across J Circumference Metatarsal Heads
1st Metatarsal Head to Heel (or desired boot length)
Measuring Instructions 1. 2. 3.
Measure length from the lateral malleolus (outer ankle bone) to lateral aspect Gluteal Fold and record in the corresponding box H. (All measurments in cm) Measure circumferences where indicated by the black dots from the lateral malleolus (outer ankle bone) and record in the corresponding lines A, B, C, C1; Measure circumference where indicated by the black dots from the lateral aspect Top of Patella: and record in the corresponding lines D, E, F (Right/Left). Measure foot circumferences and length and record on lines I, J, K.
ph: 866.931.0876
43
fax: 616.931.0052
CompreSleeve™- TH Sizing Chart Small
Medium
Large
X-Large
F
48 - 58
56 - 66
64 - 74
74 - 84
E D
43 - 53 38 - 48
51 - 61 46 - 56
58 - 68 53 - 63
68 - 78 63 - 73
C1 C B A H
32 - 42 29 - 39 24 - 34 20 - 29
37 - 47 34 - 44 29 - 39 21 - 30
42 - 52 39 - 49 33 - 43 25 - 36
51 - 61 48 - 58 41 - 51 32 - 42
X-Short: 61 - 66
Short: 66 - 71
Regular: 71 - 76
Tall: 76 - 81
X-Tall: 81 - 86
ComprSleeve™ - TH Item Numbers LEFT
RIGHT
SIZES
X-Short
Short
Regular
Tall
Small
1501-THXS-L
1501-THS-L
1501-THR-L
1501-THT-L
X-Tall
X-TShort
Short
1501-THXT-L 1501-THXS-R 1501-THS-R
Regular
Tall
X-Tall
1501-THR-R
1501-THT-R
1501-THXT-R
Medium
1502-THXS-L
1502-THS-L
1502-THR-L
1502-THT-L
1502-THXT-L 1502-THXS-R 1502-THS-R
1502-THR-R
1502-THT-R
1502-THXT-R
Large
1503-THXS-L
1503-THS-L
1503-THR-L
1503-THT-L
1503-THXT-L 1503-THXS-R 1503-THS-R
1503-THR-R
1503-THT-R
1503-THXT-R
X-Large
1504-THXS-L
1504-THS-L
1504-THR-L
1504-THT-L
1504-THXT-L 1504-THXS-R 1504-THS-R
1504-THR-R
1504-THT-R
1504-THXT-R
MedaFit™ - TH Sizing Chart Small
Small MAX
Medium
Med MAX
Large
Large MAX
X-Large
F
48 - 58
5 6- 66
56 - 66
64 - 74
64 - 74
74 - 84
74 - 84
E D
43 - 53 38 - 48
51 - 61 46 - 56
51 - 61 46 - 56
58 - 68 53 - 63
58 - 68 53 - 63
68 - 78 63 - 73
68 - 78 63 - 73
C1 C B A H
32 - 42 29 - 39 24 - 34 20 - 29
37 - 47 34 - 44 29 - 39 21 - 30 Short: 61 - 71
42 - 52 39 - 49 33 - 43 25 - 36
Regular: 71 - 81
51 - 61 48 - 58 41 - 51 32 - 42
Tall: 81 - 91
MedaFit™ - TH Item Numbers
www.BiaCare.com
SIZES
Short
Short/Max
Regular
Reg./Max
Tall
Tall/Max
Small
1201-THS
1201-THSM
1201-THR
1201-THRM
1201-THT
1201-THTM
Medium
1202-THS
1202-THSM
1202-THR
1202-THRM
1202-THT
1202-THTM
Large
1203-THS
1203-THSM
1203-THR
1203-THRM
1203-THT
1203-THTM
X-Large
1204-THS
N/A
1204-THR
N/A
1204-THT
N/A
44
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Rev. 11/11
ArmAssist™ Custom Measuring Form PO#:
Contact Name:
Company:
Phone:
Bill-To Address:
Ship-To Address: Patient:
Foam (check one):
Arm (check one):
q q
Regular Right
q q
Sex:
Age:
Advanced (WaveFoam™)
Date:
Ht:
Wt:
Left = Locations measured along dorsal aspect
Circumference
Anterior Axilla
Posterior Axilla 25cm 20cm
A
B
15cm
Length
Length
10cm 5cm
Elbow Crease
Ø Point
Elbow
5cm
C
10cm
Length
15cm 20cm 25cm
Ulnar Styloid
D Length Third Metacarpal Head
E
E
Width
Width of hand across dorsal metacarpal heads ph: 866.931.0876
45
fax: 616.931.0052
Measuring Instructions ArmAssist™
All measurements must be taken in a straight line, unless otherwise specified, with the tape measure following the contours of the limb. Do not pull the tape tight; hold it lightly against the skin.
*Digital photos are required when irregular shapes are present
STEP 1 - Locate Landmarks 1. 2. 3.
Encircle arm with tape measure located as high as possible at axilla. Mark on the proximal edge of tape at the anterior, dorsal, and posterior aspects of arm, and record the circumference on the line labeled Posterior Axilla. Encircle arm at the elbow with the proximal edge of a tape measure aligned at the elbow crease and the Olecranon Process (elbow). Mark the dorsal aspect of the arm along this edge, and record the circumference on the line labeled Elbow (Ø Point).
Encircle arm at the wrist with the distal edge of a tape measure aligned with the ulnar styloid process. Mark the dorsal aspect of the arm along this edge, and record the circumference on the line labeled Ulnar Styloid.
STEP 2 - Locate Circumference Measurement Positions 1.
2.
Starting with “0” of the tape measure at your mark on the dorsal aspect of the elbow, mark the dorsal aspect of the proximal arm in 5cm increments up to the mark made for the Posterior Axilla on the dorsal aspect of the arm. Starting with “0” of the tape measure at your mark on the dorsal aspect of the elbow, mark the dorsal aspect of the proximal arm in 5cm increments up to the mark made for the
Ulnar Styloid on the dorsal aspect of the arm.
STEP 3 - Measure Lengths 1.
2. 3.
4.
Measure proximal arm from anterior axilla (inside armpit) to elbow crease and record length in box marked Length A.
Measure proximal arm from posterior axilla (outside armpit) to the Olecranon Process (elbow) and record length in box marked Length B.
Measure the distal arm along dorsal aspect from the elbow (as marked at the mid-point between Olecranon Process and elbow crease) to the Ulnar Styloid as indicated on diagram and record length in box marked Length C. Measure hand from your mark on dorsal aspect of wrist to the third metacarpal head and record length in box marked Length D.
STEP 4 - Measure Circumferences 1.
2. www.BiaCare.com
Encircle arm with a tape measure at each mark located between the elbow and axilla, and record each circumferences on the line corresponding to each position.
Encircle arm with a tape measure at each mark located between the elbow and Ulnar Styloid, and record each circumference on the line corresponding to each position.
46
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Rev. 11/11
LegAssist™ - BK Custom Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address: Patient:
Foam (check one): Arm (check one):
q
q q
Regular q Right q
Sex:
Age:
Date:
Ht:
Advanced (WaveFoam™) Left
Wt:
Shoe Size:
MedaBoot™ (optional charges apply) = Locations measured along lateral aspect of leg
Circumference * Follow contour of limb on all measurements Anterior Length Medial Length Posterior Length Lateral Length
cm 40 cm
A
A B C C D D
Bottom of Patella (If req’d)
35 cm 30 cm 25 cm
B
20 cm 15 cm 10 cm 5 cm ø Point
M
I
Circumference of Ankle Bend and Heel
* Note: order a BK Super if greatest circumference is > 60 cm
M
J
K 1st Metatarsal Head to Heel (or desired boot length)
ph: 866.931.0876
Top of foot 3rd Metatarsal Head to Ankle Bend
47
Circumference across Metatarsal Heads
Foot Measurments CompreBoot™PLUS Included MedaBoot™ optional
I J K M fax: 616.931.0052
Measuring Instructions
LegAssist™ - BK (Below Knee)
All measurements must be taken in a straight line, unless otherwise specified, with the tape measure following the contours of the limb. Do not pull the tape tight; hold it lightly against the skin.
*Digital photos are required when irregular shapes are present
STEP 1 - Locate Landmarks Encircle leg with top edge of tape measure located at the bottom of patella. Mark leg on this edge of tape at the anterior, lateral, posterior, and medial aspects, and record the circumference on the line labeled Bottom of Patella.
1. 2.
Encircle leg with bottom edge of tape measure aligned with the ankle bend. Mark leg on this edge of tape at the anterior, lateral, posterior, medial aspects, and record the circumference on the line labeled Ankle Bend (Ø Point).
STEP 2 - Locate Circumference Measurement Positions 1.
Starting with “0” of the tape measure at your mark on the lateral aspect of the Ankle Bend, mark the leg in 5 cm increments up to your mark on the lateral aspect of the bottom of patella.
STEP 3 - Measure Lengths 1. 2. 3. 4.
5.
6.
Measure leg from your mark on the anterior aspect of ankle bend to your mark on anterior aspect of bottom of patella and record length on Line A.
Measure leg from your mark on the medial aspect of ankle bend to your mark on medial aspect of bottom of patella and record length on Line B.
Measure leg from your mark on the posterior aspect of ankle bend to your mark on the posterior aspect of bottom of patella and record length on Line C.
Measure leg from your mark on the lateral aspect of ankle bend to your mark on the lateral aspect of bottom of patella and record on Line D.
Measure foot from 1st metatarsal head to heel and record length on Line K. (or desired boot length). Measure Top of Foot from the 3rd Metatarsal Head to Ankle Bend on Line M.
STEP 4 - Measure Circumferences 1.
2.
3.
www.BiaCare.com
Encircle leg with a tape measure at each mark located between the ankle bend and bottom of patella, and record each circumference on the line corresponding to each position.
Encircle the Ankle Bend and Heel with a tape measure and record the circumference on Line I.
Encircle the foot across the metatarsal heads and record the circumference on Line J.
48
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Rev. 11/11
LegAssist™ - LCS Custom Measuring Form PO#:
Contact Name:
Company:
Phone:
Bill-To Address:
Ship-To Address: Patient:
Foam (check one):
Date:
Sex:
Regular
Advanced (WaveFoam™)
Age:
Ht:
Leg (check one):
Hip Attatchment (optional - charges apply) (Measurements F & G required)
Wt:
Right
Waist
Left
G
Waist at bottom of belt
Follow contour of limb on all measurements
(All measurments in cm)
Lateral Length Medial Length Posterior Length Anterior Length
Lateral Length Medial Length Posterior Length Anterior Length
A1 B1 C1 D1
A2 B2 C2 D2
= Locations measured along lateral aspect
A1
Gluteal Fold
30 cm 25 cm 20 cm 15 cm 10 cm 5 cm ø Point 5 cm 10 cm
Pick a zero point*
A2
Bottom of Garment* *See instructions
Note: order a LCS Super if greatest circumference is > 90 cm
ph: 866.931.0876
F
Circumference *
49
D1
C1 B1
D2
C2
B2
Approximatley 8-10cm from bottom of lobule
fax: 616.931.0052
Measuring Instructions
LegAssist™ - LCS (Lobule Compression System)
All measurements must be taken in a straight line, unless otherwise specified, with the tape measure following the contours of the limb. Do not pull the tape tight; hold it lightly against the skin.
*Digital photos are required.
Please take photos after taking measurments, with measurement marks on limb visible. STEP 1 - Locate Landmarks 1. 2. 3.
S elect a zero point in the lower region of the thigh, circle leg with tape measure, make certain the tape is parallel with the floor. Mark leg on top edge of tape at the anterior, lateral, posterior, and medial aspects, and record the circumference on the line labeled Ø Point.
E ncircle leg with bottom edge of tape measure aligned parallel with the floor and located approximatley 8-10cm from bottom of lobule. Mark leg on this edge of tape at the anterior, lateral, posterior, medial aspects, and record the circumference on the line labeled Bottom of Garment. ncircle leg with top edge of tape measure aligned with the Gluteal Fold. Mark leg on this edge E of tape at the anterior, lateral, posterior, medial aspects, and record the circumference on the line labeled Gluteal Fold.
STEP 2 - Locate Circumference Measurement Positions 1. 2.
Starting with “0” of the tape measure at your mark on the lateral aspect of the Ø Point, mark the leg in 5cm increments down to your mark on the lateral aspect of the Bottom of Garment. Repeat step 1, only this time from the Ø Point to the lateral aspect of the Gluteal Fold.
STEP 3 - Measure Lengths 1. 2. 3. 4.
Lateral Lengths (A1): Measure upper leg from your mark on lateral aspect of Ø Point to your mark on lateral aspect of Gluteal Fold and record length on Line A1.
edial Length (B1): Measure upper leg from your mark on the medial aspect of Ø Point to M your mark on medial aspect of Gluteal Fold and record length on Line B1.
osterior Length (C1): Measure upper leg from your mark on the posterior aspect of Ø Point to P your mark on posterior aspect of Gluteal Fold and record length on Line C1. Anterior Length (D1): Measure upper leg from your mark on the anterior aspect of Ø Point to your mark on anterior aspect of Gluteal Fold and record length on Line D1. (Continued on next page)
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50
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Rev. 11/11
Measuring Instructions
LegAssist™ - LCS (Lobule Compression System) STEP 3 - Measure Lengths (continued) 5. 6. 7. 8.
Lateral Lengths (A2): Measure lower leg from your mark on lateral aspect of Ø Point to your mark on lateral aspect of Bottom of Garment and record length on Line A2. Medial Length (B2): Measure lower leg from your mark on the medial aspect of Ø Point to your mark on medial aspect of Bottom of Garment and record length on Line B2. Posterior Length (C2): Measure lower leg from your mark on the posterior aspect of Ø Point to your mark on posterior aspect of Bottom of Garment and record length on Line C2.
Anterior Lengths (D2): Measure lower leg from your mark on anterior aspect of Ø Point to your mark on anterior aspect of Bottom of Garment and record length on Line D2.
STEP 4 - Measure Circumferences 1. 2.
pper: Encircle leg with tape measure at each mark located on the lateral aspect between the Ø Point U and Gluteal Fold, and record each circumference on the corresponding line, as applicable.
ower: Encircle leg with tape measure at each mark located on the lateral aspect between the Ø Point L and Bottom of Garment, and record each circumference on the corresponding line, as applicable.
STEP 5 - Hip attachment (Optional) 1. 2.
ph: 866.931.0876
Measure from lateral aspect of Gluteal Fold to lateral aspect of hip at the desired location for the bottom of the belt and record length on line F.
Measure circumfrence of torso at the desired location for the belt and record circumfrence on line G.
51
fax: 616.931.0052
NOTES:
www.BiaCare.com
52
[email protected]
Rev. 11/11
CompreFlex,™ LegAssist™ - TH Custom Measuring Form Company:
PO#:
Contact Name:
Phone:
Bill-To Address:
Ship-To Address: Patient:
Foam (check one):
Regular
MedaBoot™ (optional - charges apply)
(All measurments in cm) Lateral 1 Length
A
Advanced (WaveFoam™)
Hip Attatchment (optional - charges apply)
Follow contour of limb on all measurements
Medial Length
Sex:
C1
Anterior Length
D1
Knee Space
E
Ht:
Wt:
Leg (check one):
Right
Waist
Straps over knee
= Locations measured along lateral aspect
G Waist at bottom of belt
A1
Gluteal Fold
35 cm 30 cm 25 cm 20 cm 15 cm 10 cm 5 cm
D1 C1 B1
ø Point
Top of Patella
E
Mid Patella
ø Point
Bottom of Patella
Lateral Length
A2
Medial Length
B2
10 cm
Posterior Length
C2
20 cm
Anterior Length
5 cm 15 cm
CompreBoot™PLUS Included MedaBoot™ optional
K
B2
35 cm (If req’d)
40 cm
A2
Ankle Bend * Note: order a TH Super if greatest circumference is > 90 cm
I
M
Top of foot 3rd Metatarsal Head to Ankle Bend
J
Circumference across Metatarsal Heads
Circumference of Ankle Bend and Heel
K
M ph: 866.931.0876
C2
30 cm
I J
No straps provided over knee unless box checked above
D2
25 cm
D2
Foot Measurments
Left
F
Circumference *
B1
Posterior Length
Age:
Date:
53
1st Metatarsal Head to Heel (or desired boot length)
fax: 616.931.0052
Measuring Instructions
LegAssist™ - TH (Thigh High)
All measurements must be taken in a straight line, unless otherwise specified, with the tape measure following the contours of the limb. Do not pull the tape tight; hold it lightly against the skin.
*Digital photos are required when irregular shapes are present
STEP 1 - Locate Landmarks 1. 2. 3. 4.
Encircle leg with top edge of tape measure located at the bottom of patella. Mark leg on this edge of tape at the anterior, lateral, posterior, and medial aspects, and record the circumference on the line labeled Bottom of Patella (Ø Point).
Encircle leg with bottom edge of tape measure aligned with the ankle bend. Mark leg on this edge of tape at the anterior, lateral, posterior, medial aspects, and record the circumference on the line labeled Ankle Bend. Encircle leg with bottom edge of tape measure aligned with the Top of Patella. Mark leg on this edge of tape at the anterior, lateral, posterior, medial aspects, and record the circumference on the line labeled Top of Patella (Ø Point). Encircle leg with top edge of tape measure aligned with the Gluteal Fold. Mark leg on this edge of tape at the anterior, lateral, posterior, medial aspects, and record the circumference on the line labeled Gluteal Fold.
STEP 2 - Locate Circumference Measurement Positions 1.
Starting with “0” of the tape measure at your mark on the lateral aspect of the bottom of patella (Ø Point), mark the leg in 5cm increments down to your mark on the lateral aspect of the ankle bend.
2.
Repeat step 1, only this time from the Top of Patella (Ø Point) to the Gluteal Fold.
STEP 3 - Measure Lengths 1. Lateral Lengths (A1): Measure upper leg from your mark on lateral aspect of Top of Patella to your mark on lateral aspect of Gluteal Fold and record length on Line A1.
2.
Medial Length (B1): Measure upper leg from your mark on the medial aspect of Top of Patella to your mark on medial aspect of Gluteal Fold and record length on Line B1.
3. Posterior Length (C1): Measure upper leg from your mark on the posterior aspect of Top of Patella to your mark on posterior aspect of Gluteal Fold and record length on Line C1.
4. Anterior Length (D1): Measure upper leg from your mark on the anterior aspect of Top of Patella to your mark on anterior aspect of Gluteal Fold and record length on Line D1.
(Continued on next page)
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54
[email protected]
Rev. 11/11
Measuring Instructions
LegAssist™ - TH (Thigh High)
STEP 3 - Measure Lengths (continued)
5. Knee Space: Measure leg from your mark on the lateral aspect of Top of Patella to your mark on lateral aspect of Bottom of Patella and record length on Line E. 6.
Lateral Lengths (A2): Measure lower leg from your mark on lateral aspect of Bottom of Patella to your mark on lateral aspect of Ankle Bend and record length on Line A2.
7. Medial Length (B2): Measure lower leg from your mark on the medial aspect of Bottom of Patella to your mark on medial aspect of Ankle Bnedand record length on Line B2.
8. Posterior Length (C2): Measure lower leg from your mark on the posterior aspect of Bottom of Patella to your mark on posterior aspect of Ankle Bend and record length on Line C2.
9.
Anterior Lengths (D2): Measure lower leg from your mark on anterior aspect of Bottom of Patella to your mark on anterior aspect of Ankle Bend and record length on Line D2.
10. Measure foot from 1st Metatarsal Head to Heel and record length on Line K (or desired boot length). 11. Measure Top of Foot from the 3rd Metatarsal Head to Ankle Bend on Line M.
STEP 4 - Measure Circumferences 1.
Upper: Encircle leg with tape measure at each mark located on the lateral aspect between the Top of Patella and Gluteal Fold, and record each circumference on the corresponding line.
3.
Lower: Encircle leg with tape measure at each mark located on the lateral aspect between the Bottom of Patella and Ankle Bend, and record each circumference on the corresponding line.
2.
4.
Knee: Encircle leg with a tape measure at Mid Patella and record the circumference on the corresponding line.
Encircle the Ankle Bend and Heel with a tape measure and record the circumference on Line I.
5.
Encircle the foot across the metatarsal heads and record the circumference on Line J.
1.
Measure from lateral aspect of Gluteal Fold to lateral aspect of hip at the desired location for the bottom of the belt and record length on line F.
STEP 5 - Hip attachment (Optional)
2.
ph: 866.931.0876
Measure circumfrence of torso at the desired location for the belt and record circumfrence on line G.
55
fax: 616.931.0052
New Dealer Application Attention:
Fax:
Date:
Sales Dept.
616-931-0052
Account Name:
Owners name:
Accounts Payable Contact:
Phone Number:
Fax Number:
Email:
Bill to Address:
Ship to Address:
Bill to State:
Bill to City: :
Does your company have a DBA or AKA?
Yes
Bill to Zip:
No
Ship to Zip:
Purchase orders required?
Ship to Zip:
Yes
Ship to Zip: :
No
If YES: Name of DBA or AKA Tax - Exempt?
Yes
No
Federal Tax ID (FEIN) number: .
Business start date:
Expected monthly volume:
Bank reference: Bank name:
City:
Checking account number:
Bank phone number:
State:
Bank contact:
Trade references: Vendors you purchase from on a net–30 basis. (NO leases or office supply vendors) Name:
Account#
Zip
Phone number
Name:
Account#
Zip
Phone number
Name:
Account#
Zip
Phone number
Authorized Signature (*required*) * I authorize release of any credit information on my company to the BiaCare Corporation and I agree to the terms and conditions set fourth.
Signature
Date:
Credit application – request for open credit terms – net 30 days / customer is responsible for collection fees, court costs, and reasonable attorney fees to collect unpaid accounts.
BiaCare Corporation 140 W. Washington, Suite 100, Zeeland, MI 49464 • p: 616.931.0876 • f: 616.931.0052 • toll free: 866.931.0876 • email:
[email protected] Revised: 2.10
www.BiaCare.com
56
[email protected]
Rev. 11/11
Dealer Order Form Dealer Name:______________________________________ Dealer#_________________________ Contact name:_____________________________________ Tel #:____________________________ P.O.#______________________________________________ Fax:____________________________ Order date:__________________Patient Name (optional):__________________________________ Ship to:___________________________________________________________________________ Bill to:____________________________________________________________________________
Item Number
Product Description
Qty.
Price
Extended Total
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Total
To Order
(less S & H)
ph: 866.931.0876
Fax to: BiaCare Corporation - 616.931.0052 Call Toll Free: 866.931.0876 Email to:
[email protected] Mail to: BiaCare Corporation, 140 W. Washington Ave., Suite 100, Zeeland, MI 49464
57
fax: 616.931.0052
Placing an Order Phone
Call 866.931.0876 to speak with a Sales Professional and place your order. It may be best to call if this is a first time order, or you have any questions.
Fax
Fax a completed Dealer Order Form (pdf form available at www.BiaCare.com) to 616.931.0052. An order confirmation will be e-mailed (or faxed back if preferred).
Mail
If your order includes a check, or other items that cannot be faxed, e-mailed, etc., please mail your completed Order Cover Sheet and Order Form to:
BiaCare Corporation ATTN: New Orders 140 W. Washington Ave., Suite 100 Zeeland, MI 49464 All dealer prices are subject to change without notice.
Dealer Account Payment Options Net 30. Balance due within thirty days of the date on the invoice. Credit approval required.
Warranty Policy MedAssist™ Fit Guarantee
All MedAssist™ custom compression garments are guaranteed to be made to the measurements provided. If garment is not made to measurements it will be altered free of charge if notified within ten (10) days of receiving the garment. Other alterations will be made and the standard alteration fee will apply.
Compression Wear
All compression garments are guaranteed for workmanship for six months from the date of purchase. If the product fails due to inferior workmanship within six months, repairs or replacement will be made at no charge.
Therapy Supplies
Therapy supplies are guaranteed to perform as represented in sales literature. If for any reason the supplies do not perform up to expectation, supplies may be returned for credit.
MedaFit™ Limited Lifetime Warranty
All MedaFit™ garments purchased after 01/01/2012 carry a limited lifetime warranty on the outer compression shell for the original purchaser. Normal wear items, including the replaceable foam liner, straps and accessories are covered by the standard six month warranty. For complete product warranty terms and conditions, please visit: BiaCare.com/Warranty
Return Policy
Custom Compression Garments
Custom compression garments are non returnable.
Standard Compression Garments
Listen. Imagine. Deliver.
All products are: (Unless indicated otherwise)
1. Free of natural latex 2. Can be machine washed & dried 3. Made in the USA
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Standard compression garments may be returned for credit or exchange if notified within 7 days of receipt and the return arrives within 21 days of original ship date. Returns must be unused, in new condition, and in original packaging with all packaging materials and documents. Credit will not be given or exchange initiated until BiaCare Medical has opportunity to inspect the returned merchandise. Shipping charges will not be credited. A 20% restock fee will be applied to all returns.
Compression Supplies
Supplies may be returned for credit or exchange if notified within 7 days of receipt and the return shipment arrives within 21 days of the original ship date. Returns must be unused, in new condition, and in original undamaged packaging. Credit will not be given or exchange initiated until BiaCare Medical has opportunity to inspect the returned merchandise. Shipping charges will not be credited. A 20% restock fee will be applied to all returns.
58
[email protected]
Listen. Imagine. Deliver.
140 W. Washington Ave., Suite 100 Zeeland, MI 49464 www.BiaCare.com ph: 616.931.0876 fax: 616.931.0052
toll free: 866.931.0876 Visit our product websites: ChipSleeve.com CompreFit.com CompreFlex.com CompreSleeve.com FoamSleeve.com GeniFit.com MedaFit.com
