RGO

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

  • Legacy form will no longer be accepted.

  • Please do not print the Review page.

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

  • RGO

    Intake Information
  • Format: (000) 000-0000.
    • Patient Information: 
    • Affected Side:*
    • Weight Unit:

    • Submission Type:

      • Plaster Cast: Negative or Positive

        Please include a printed Work Order with the cast when shipping.
    • Scan being submitted with order: (Deprecated-Do Not Delete)*

    • The Shipping section is now at the end of the form.

  • RGO

    Configurator
  • 0/250
  • Please indicate measurement unit:*
    • Measurements: 
    • Patient Measurements
    • Rows
    • Rows
    • Rows
    • Rows
    • Materials/Design: 
    • Reciprocator:*
    • Hip Joints:*
    • Hip Joints:*
    • Upper Bars:*
    • LSO Material:*

    • Plastic

    • i

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

    • Plastic Type:*
    • Finished Plastic Thickness:*

    • Transfers are available for Copolymer plastic.

    • Plastic Color:*
    • Plastic Color/Transfer:*

    • Special Order Transfer Papers can increase device turnaround time.

    • Stocked Transfers Container #1
    • Stocked Transfers Container #2

    • PLEASE SELECT DIFFERENT OPTIONS FOR TRANSFER PAPERS.

    • Padding/Finishing: 
    • Liner:*
    • Liner:*
    • Strap/Liner Color:*
    • Anterior Closure:*

  • RGO

    Notes
  • Who would you like a call from?*
  • 0/250
  • Browse Files
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  • Return Shipping Method:
  • Shipping is same as Billing Address:*
  • Requested In-Office Date:
     - -
  • Requested In-Office Date:
     - -
  • Requested In-Office Date:
     - -
  • Requested In-Office Date:
     - -

  • Daily HFN Capacity

  • {requestedInoffice}{requestedInoffice1392}{requestedInoffice1393}{requestedInoffice1394}

    • Requested In-Office Date: 
    • Image field 1397

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

    • Today's Date:*
       - -
  • Should be Empty: