TRANFEMORAL DEFINITIVE 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 DEFINITIVE SOCKET

    Intake Information
  •  - -
  • Daily HFN Capacity

  •  - -
  •  - -
  • TRANSFEMORAL DEFINITIVE SOCKET

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

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

    • 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. 

  • TRANSFEMORAL DEFINITIVE SOCKET

    Intake Information
  • 0/250
    • Measurements: 
    • Image-1362
    • Alignment: 
    • i

      Making changes prior to definitive fabrication is not recommended.

    • Transverse Changes:

    • * * degrees from current position.

    • Coronal Changes (Angular):

    • * * degrees from current alignment.

    • Coronal Changes (Linear):

    •  *   *in from current position.

    • * *cm from current position.

    • Sagittal Changes (Angular):

    •  * * degrees from current alignment.

    • Sagittal Changes (Linear):

    •  * *in from current position.

    •  * *cm from current position.

    • Modifications: 
    • i

      Global modifications will affect the distal end of the model. 

    • Fabrication: 
    • Image-1620
    • Image-1621
    • Image-1622
    • Image-1803
    • Image-1623
    • Image-1624
    • Lock not provided. 

    • Pin not provided. 

    • Image-1804
    • Image-1807
    • Image-1808
    • Image-1809
    • Image-1810
    • Image-1812
    • Image-1811
    • Image-1625
    • Image-1737
    • Image-1627
    • Image-1641
    • Image-1683
    • Image-1684
    • Image-1698
    • Image-1688
    • Image-1629
    • Image-1689
    • Image-1690
    • Image-1630
    • Image-1631
    • Image-1632
    • i

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

    • Finishing: 
    • Image-1728
    • Image-1729
  • TRANSFEMORAL DEFINITIVE SOCKET

    Notes
  • Your order will be sent to CDC after submission along with the Scan. 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: