SOLID, SEMI-SOLID, PLS, & ARTICULATED AFO

  • Access Legacy PDF work order. Legacy form will be accepted until Aug 15th. 

  • Legacy form will no longer be accepted.

  • - Please create a new account to use the Save Draft feature - 

  • Please do not print the Review page.

    Scroll to the bottom, hit Complete and then download the work order. 

  • SOLID, SEMI-SOLID, PLS, & ARTICULATED AFO

    Intake Information

  • Please enter a correct Fab PCC#

  • HFN Rocky Hill (Cromwell) has relocated! Our new address is:
    31 Inwood Rd, Rocky Hill, CT 06067

    • Patient Information: 

    • Bilateral Symmetrical: 

      • Left and Right sides can have different Measurements
      • Same Alignment, Design and Finishing options

    • Please use the Special Order Pediatric form for Non-Standard Pediatric Designs. This form cannot be used for patients under 18.

    • Upload Scan at the end. 

    • Submission Type:

      • Plaster Cast: Negative or Positive

        Please include a printed Work Order with the cast when shipping.

    • Your order will be sent to CDC after submission. 

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      • Please complete this form. Next, after acquiring the scan via the Hanger3D app, go to Order Forms > Jotform Order and fill out the required information and submit the scan. 

        

    • The Cast Measurement fields are available at the end of the Form. 

    • Due to the scan being modified, the Alignment and Modification options will not be displayed.

      Any Alignment or Modification changes can be called out in the Notes section. 

    • Since the Positive plaster model is already modified, the Alignment and Modification options will not be displayed.

      Any Alignment or Modification changes can be called out in the Notes section. 

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    • Daily HFN Capacity

    • This option is for requests requiring a 24–48 hour turnaround. An expedite fee might apply.

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    • Requested In-Office Date: 
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    • Clinicians can still coordinate special in-office requests by emailing:
      HFN_Hypercare@hanger.com

  • SOLID, SEMI-SOLID, PLS, & ARTICULATED AFO

    Device Type

  • Tuning Principles can be applied to Solid/Semi-Solid AFOs. 

  • SOLID, SEMI-SOLID, PLS, & ARTICULATED AFO

    Configurator
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    • Tuning: 

    • Casting block Height and Toe Ramp Angle measurements are recommended.
      If Heel Wedging alone is required, please proceed to the Materials/Design Section.

    • Foot on Casting block

    • Final Ankle Position (Ankle Angle):

    • Set the Ankle in   *   ° of      *       

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    • Measurements: 

    • Submissions with Scans require measurements. Go By Impression will be disabled. 

    • Patient Measurements
    • Patient Measurements

    • Selected unit: {pleaseIndicate910}

    • Alignment: 

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      NEUTRAL is the Tibia perpendicular to the floor based on Heel Height. 

    • Final Ankle Position:

    • Set the Ankle in   *   ° of      *        

    • If "As Casted" Forefoot Alignment is required, please select "Other" and provided the as casted alignment. 

    • Final Forefoot Position:

    • Set the Forefoot in   *   ° of      *        

    • Final Hindfoot Position:

    • Set the Hindfoot in   *   ° of      *        

    • Modifications/Trimlines: 
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    • Standard Mods include:

      • 1/8" (3 mm) buildup at the Malleoli, Navicular and Base of the 5th. 
      • 1/8" (3 mm) reduction at the Medial Longitudinal Arch Apex. 
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    • Intrinsic Heel Skive requires external posting/wedging.

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      Standard Default: 1/8" deflection at Malleoli away from the leg to reduce edge pressure

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      • Standard: 1/8" deflection from the leg with extra accommodation at the malleoli to reduce edge pressure.
      • Gutter: Material added to create a "gutter" shape so the trimlines are inline with the apex of the buildups. (Commonly used for Positioning or Night time Stretching AFOs).
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    • Provided Finished Foot Plate Length: {finishedPlastic1000}{finishedPlastic999}

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    • Materials/Design: 

    • {intrinsicHeel990} Intrinsic Heel Skive was selected.

    • Posting:

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    • Posting options will not be available if a Heel Wedge is selected.

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    • Ankle Joints

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    • Plastic

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      Finished Plastic Thickness will be within 10% of the requested thickness. 

    • Special Order Transfer Papers can increase device turnaround time.

    • PLEASE SELECT DIFFERENT OPTIONS FOR TRANSFER PAPERS.

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    • Padding: 

    • Additional Padding

    • Finishing: 
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  • SOLID, SEMI-SOLID, PLS, & ARTICULATED AFO

    Notes

  • Your order will be sent to CDC after submission along with the Scan. No futher action is needed.

    (No Entry required at the LEO portal)

  • Your order will be sent to CDC after submission. No futher action is needed.

    (No Entry required at the LEO portal)

    • Please complete this form. Next, after acquiring the scan via the Hanger3D app, go to Order Forms > Jotform Order and fill out the required information and submit the scan. 

      

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