TRANSFEMORAL DIAGNOSTIC SOCKET Logo

  • Please do not print the Review page.

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

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

  • TRANSFEMORAL DIAGNOSTIC SOCKET

    Intake Information
  •  - -

  • Daily HFN Capacity

  •  - -
  •  - -

  • TRANSFEMORAL DIAGNOSTIC SOCKET

    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. 

  • TRANSFEMORAL DIAGNOSTIC SOCKET

    Intake Information
  • 0/250
    • Measurements: 
      • Always scan/cast & measure over the liner you are fitting with.
      • Length measurements must be taken from the Perineum. 
    • Image-1362
    • Design: 

    • Brim Style Descriptions

    • Image-1649
    • Image-1650
    • Image-1651
    • Image-1652
    • Image-1653
    • Image-1654
    • Image-1655
    • Image-1656
    • Image-1657
    • Image-1658
    • Image-1659
    • Image-1660
    • Image-1661
    • Image-1662
    • Image-1663

    • Alignment (Optional): 

    • Fabrication: 
    • Image-1620
    • Image-1621
    • Image-1623

    • Lock not provided. 

    • Image-1674
    • Image-1703
    • Image-1625
    • Image-1626
    • Image-1628
    • Image-1629

  • TRANSFEMORAL DIAGNOSTIC SOCKET

    Notes

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

    (No Entry required at the Sharepoint portal)

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • 0/250
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Should be Empty: