BURN AND PROTECTIVE MASKS

  • Legacy form will no longer be accepted.

  • Access Legacy PDF work order. Legacy form will be accepted until Mar 4th. 

  • Please do not print the Review page.

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

  • BURN AND PROTECTIVE MASKS

    Intake Information

  • Please enter a correct Fab PCC#

    • Patient Information: 

    • Your order will be sent to CDC after submission. 

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    • Daily HFN Capacity

    • {requestedInoffice}{requestedInoffice1236}{requestedInoffice1367}{requestedInoffice1368}

    • Requested In-Office Date: 
    • Image-1371

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

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

  • {deviceType1350}

    Configurator

    • Measurements: 
    • Image-1301
    • Materials/Design: 

    • Plastic

    • i

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

    • Silon is discontinued and no longer available. 

    • Image-1351
    • Finishing: 

  • {deviceType1350}

    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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