Clone of PARTIAL HAND SILICONE SOCKET & 3D FRAME

  • 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 Mar 4th. 

  • PARTIAL HAND SILICONE SOCKET & 3D FRAME

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

    • Submission Type:

      • Physical Device

        Please include a printed Work Order with the device when shipping.

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

  • PARTIAL HAND SILICONE SOCKET & 3D FRAME

    Configurator

  • FOR BEST RESULTS, START WITH A DIAGNOSTIC SOCKET

  • Raven Base Code:
  • Device Type:
  • 0/1500

  • PARTIAL HAND SILICONE SOCKET & 3D FRAME

    Configurator
  • Please indicate measurement unit:*
  • Device Design Options:*
    • Design: 
    • Silicone Socket:*
    • Component Design Options:
    • Alignment: 
    • Static Digit Flexion:*
    • Static Digit Flexion:*
    • Split Hand Digit Flexion:*
    • Split Hand Digit Flexion:*
    • Static Thumb Flexion:*
    • Static Thumb Flexion:*
    • Split Hand Thumb Flexion:*
    • Split Hand Thumb Flexion:*
    • Static Oppositional Digit: 
    • Finger Location:*
    • Left Full Digits:
    • Right Full Digits:
    • Left Partial Digits:
    • Right Partial Digits:
    • Point Design: 
    • Finger Location:*
    • Left Full Digits:
    • Right Full Digits:
    • Left Partial Digits:
    • Right Partial Digits:
    • Left Thumb:
    • Right Thumb:
    • M Fingers: 
    • Finger Location:*
    • Left Full Digits:
    • Right Full Digits:
    • Left Partial Digits:
    • Right Partial Digits:
    • Split Hand PX: 
    • Finger Location:*
    • Finishing: 
    • Finishing: 
    • 3D Frame Paint Colors:*

  • PARTIAL HAND SILICONE SOCKET & 3D FRAME

    Notes

  • Please contact 3Dprinting@hanger.com with questions. 

  • Who would you like a call from?
  • 0/1500
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Return Shipping Method:
  • Shipping is same as Billing Address:*
    • Check without silicone      - 7 days
    • Definitive without silicone - 10 days
    • Check with silicone           - 12 days
    • Definitive with silicone      - 15 days
  • Requested In-Office Date:
     - -
  • Requested In-Office Date:
     - -
  • Requested In-Office Date:
     - -
  • Requested In-Office Date:
     - -

  • Daily HFN Capacity

  • {requestedInoffice}{requestedInoffice1834}{requestedInoffice1835}{requestedInoffice1836}

  • **Mold/Impression should capture distal alignment, finger tip to 1" proximal to Styloids.

  • Design Input Requirements:*

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

    • Requested In-Office Date: 
    • Image field 1839

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

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