TMA INSERT AND AFO COMBO

  • 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. 

  • TMA INSERT AND AFO COMBO

    Intake Information
    • Patient Information: 

    • Bilateral Symmetrical: 

      • Left and Right sides can have different Measurements
      • Same Alignment, Design and Finishing options

    • Submission Type:

      • Plaster Cast: Negative or Positive

        Please include a printed Work Order with the cast when shipping.
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    • Daily HFN Capacity

    • {requestedInoffice}{requestedInoffice1373}{requestedInoffice1374}{requestedInoffice1375}

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

  • TMA INSERT AND AFO COMBO

    Device Type

  • Design: Cork Base, Poron Inner, Plastazote Top Cover

  • Indication: Fixed/Painful Ankle

    Design: Mid-Calf, Copoly, Solid AFO, SMO, TMA insert

  • Indication: Compromised Skin, Equino-Varus, PF Contracture

    Design: Mid-Calf, Copoly, Articulated AFO, SMO, TMA Insert, Launchpad Joint and X

  • TMA INSERT AND AFO COMBO

    Configurator
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    • Tuning: 

    • Casting block Height and Toe Ramp Angle measurements are recommended.
      If Heel Wedging alone is required, please proceed to the Materials/Design Section.

    • Foot on Casting block

    • Final Ankle Position (Ankle Angle):

    • Set the Ankle in   *   ° of      *       

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    • Measurements: 
    • Patient Measurements
    • Patient Measurements
    • Patient Measurements

    • Selected unit: {pleaseIndicate910}

    • Design/Requirements: 

    • All Requirements need to be met before you can proceed. 

  • TMA INSERT AND AFO COMBO

    Notes
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