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  • Access Legacy PDF work order. Legacy form will be accepted until Nov 1st. 

  • Please do not print the Review page.

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

  • XOS BRACE

    Intake Information

  • Please enter a correct Fab PCC#

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  • Daily HFN Capacity

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  • XOS BRACE

    Patient Information

  • The Scan Upload is available at the end of the Form. 

    • Please complete and submit the form and print out the Work Order PDF. In the Hanger 3D app, go to Order Forms > Take a Picture and upload the printed PDF along with your 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. 

  • XOS BRACE

    Configurator
    • 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      *       

    • Image-874
    • Measurements: 
    • Patient Measurements
    • Materials/Design: 

    • Strut is provided with the kit.
      Complete this section only if the design deviates from kit.

  • XOS BRACE

    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)

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