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.
Bilateral Symmetrical:
Submission Type:
The Shipping section is now at the end of the form.
i
NEUTRAL is the Tibia perpendicular to the floor based on Heel Height.
Final Ankle Position:
Set the Ankle in Degrees* ° of Dorsiflexion Plantarflexion*
Final Forefoot Position:
Set the Forefoot in Degrees* ° of Varus Valgus*
Final Hindfoot Position:
Set the Hindfoot in Degrees* ° of Inversion Eversion*
Standard Mods include:
Standard Default: 1/8" deflection at Malleoli away from the leg to reduce edge pressure
Provided Finished Foot Plate Length: {finishedPlastic1000}{finishedPlastic999}
Posting/Wedging:
Finished Plastic Thickness will be within 10% of the requested thickness.
PLEASE SELECT DIFFERENT OPTIONS FOR TRANSFER PAPERS.
Additional Padding
Daily HFN Capacity
{requestedInoffice}{requestedInoffice1530}{requestedInoffice1531}{requestedInoffice1532}
Clinicians can still coordinate special in-office requests by emailing:HFN_Hypercare@hanger.com