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1 ORR ORM USTOM PRSSUR GRMNTS SUMIT THIS ORM WITH LL ORRS, RORRS & LTRTIONS Numr ORR T PT N Y T SHIP TO Nw lty xstn Spy Sppn M: Grmnt(s) Orr Prt No. srpn Qty L Qty R Totl Qty MM//YYYY MM//YYYY RQUIR PTINT INORMTION o rt Gnr MM//YYYY IS THIS URN PTINT? Ys No sr Prssur: mmh Otr: ILITY INORMTION Purs Orr # NOT: usm Prssur Grmnts r vll only unr pysn s orrs. m Trumt Sr Lympm Msur y lln ontt lln Tlpon Qukst wy ontt you: Tlpon/Pr/x/ml Nm o lty Sppn rss lln rss T ull stnn rss. Inlu t prtmnt, room numr, prtmnt numr, t. I sppn ptnt, nlu t ptnt s pon numr. T rss wr w wll sn our nvo rnt rom t sppn rss. I w r ll nsurn, wrt nsurn n prov normn low. I ILLING INSURN/WORMN'S OMP/HLTH PLN NOT: Pls lv ts sps lnk unlss you wnt us try lln t ptnt s lt pln. tt opy o t prsrpn, lttr o ml nssty, nsurn r, n, vll, opy o t osptl st. NVR RSN OL HRTS OR OL MSURMNTS TO RORR IO-ONPTS US ONLY (Pls wrt notn n ts lok) Insurn rrr Insurn Tlpon o Injury MM//YYYY ownlo ts rts t: IO-ONPTS, IN., PHONIX, RIZON
2 H & N usm Prssur Grmnts r vll only unr Pysn s Orr 32. Msk ull 33. n Strp w/ lp p 32. Msk opn 34. H n 33. n Strp rulr 35. ollr om 35. ollr Pllow STNR TURS Msk: Hook & loop losur wt r protr n Strp: Hook & loop losur H n: Slp-on, no losur ollr: Hook & loop losur Rr t Msurn Mnul RQUIR MSURMNTS Msk: n Strp: H n: ollr: LL -,, &, j & k, n sr t o n n ront, n sr t o ollr MS MSURMNTS HIN STRP MSURMNTS TWN YS k IN RONT O R (lt or rt) j j k u IO-ONPTS, IN., PHONIX, RIZON
3 HN usm Prssur Grmnts r vll only unr Pysn s Orr 3. Guntlt wrst 4. Guntlt low 5. Guntlt xll HN TRINGS R RQUIR or ll Glovs, Guntlts, & Mttns 1 LT HN RIGHT HN 6. Glov wrst 7. Glov low 8. Glov xll 9. Mttn wrst Lt n zppr: Rt n zppr: nr/tum tps los orsl Plmr Ulnr Wt ook & loop zppr sp t orsl Plmr Ulnr Wt ook & loop zppr sp t Rl Glov n Guntlt zpprs normlly opn t t proxml n o t rmnt n xtn just proxml t knukls (MP's). nr/tum tps opn Rr t Msurn Mnul Rl Us t UPPR XTRMITY HRT or n slvs lovs & untlts. Rr t Msurn Mnul or nstruns on msurn ontrt nrs. Us t n trn llustrt spl turs & opns. G RQUIR MSURMNTS Glovs: ll Mttns: ll, xpt tru J Guntlt: 1,,,,, & H J I G H I J NOT: lwys tk stns (-) rom n trn not rom t ptnt 1½" WRIST 1 TO N O INGR TO N O GLOV OR OPN TIPS u IO-ONPTS, IN., PHONIX, RIZON
4 LT HN TRING GUI Unvrsty rv, Ponx, rzon, U.S VOI: / X: / RQUIR n onjunn wt HN Posn n tr ptnt's n wtn outln orrt Inorrt 0.8x4.00 I t lov s v opn nr tps, mrk t sr ns o t nrs on t trn wt t mrks. Pls o not sn n trn wut sl rw 3-n lon ln n ts ox Tk msurmnts - on t Hn Msurmnt rt rom t n trn. Pl wrst rs on ts ln u IO-ONPTS, IN., PHONIX, RIZON
5 RIGHT HN TRING GUI Unvrsty rv, Ponx, rzon, U.S VOI: / X: / RQUIR n onjunn wt HN Posn n tr ptnt's n wtn outln 0.8x4.00 orrt Inorrt Pls o not sn n trn wut sl rw 3-n lon ln n ts ox I t lov s v opn nr tps, mrk t sr ns o t nrs on t trn wt t mrks. Tk msurmnts - on t Hn Msurmnt rt rom t n trn. Pl wrst rs on ts ln u IO-ONPTS, IN., PHONIX, RIZON
6 TORSO usm Prssur Grmnts r vll only unr Pysn s Orr Zppr: Rulr nk Soop nk: stn low strnl not Turtl nk: ront or k ¾" 1" 1½" 2" 2½" xpnson pnl: Lt s Rt s (ult xpnson pnl lon s ltrl) Sot rmpt pnls (N/) Ms rmpt pnls (N/) Hook & loop zppr sp t Wst ook & loop ts tt pnts (N/) Rr t Msurn Mnul or Vst (Itms 30, 31) rqur:,,,, G, H,,, or ult ml: rssr up sz rso rumrn ovr rsts opnl:, k (s llustrns low) or oy r or Sut (Itms 24, 25, 26, 27, 28, 29) rqur: ll, xpt n k or ult ml: rssr up sz rso rumrn ovr rsts opnl: Non or otr rso rmnts rr t Msurn Mnul IRUMRNS ult ml Torso H or ult mls s rtly low t rsts. on't ort tk n nl rumrn o t rso ovr t rsts. ISTNS ult ml Torso G Z wst wst IRUMRNS Ml & l Torso H or ult mls n lrn, s lwy twn n. G ISTNS Ml & l Torso Z 24. oy r slvlss 29. Sut Slv or nkl 25. oy r slv 30. Vst or ult mls: rssr up sz: st rumrn (ovr nppls): slvlss HOW TO MSUR IRUMRNS G & H roml Pross H Msur H & G wt rm own n pl t msurn tp stl (wy) rom t romon. G 26. Sut Slvlss ov kn ITIONL ISTNS & IRUMRNS oy rs & oy Suts Only Z 30. Strnl Strp G L H R I L J R 27. Sut Slv ov kn 31. Vst slv 28. Sut Slvlss or nkl 34. lly n wst k wst k X wst I & J,,, n k r msur rom Z,,, n own t ront o t rso. n k r OPTIONL. Ty r xtn Vsts low wst ln, not or oy rs n oy Suts. n r vnly sp twn t wst n t lutl ol. k u IO-ONPTS, IN., PHONIX, RIZON
7 UPPR XTRMITY usm Prssur Grmnts r vll only unr Pysn s Orr Soulr lps 10. Soulr lp 10. Soulr lp 10. Soulr lp 10. Soulr lp 10. Soulr lp romon Ml/l Soulr lp Msurmnts Msur (rmol rumrn) wt rm own n pl t msurn tp stl (wy) rom t romon romon romon romon ult ml Soulr lp Msurmnts rulr ml & l rulr ml LT RIGHT strp ml strp ml strp l Soulr lps my tt ny slv tt rs t xll (No. 1, No. 2, No. 5, No. 8). Slt lp styl ov, slv styl lowr lt. ntr soulr lp msurmnts t lt n slv msurmnts low. Lt n zppr: Lnt ( not ull) orsl Plmr Ulnr Wt ook & loop zppr sp t Rl Slvs 1. Slv wrst-low or low-xll 2. Slv wrst-xll Slvs or Glovs & Guntlts 4. Guntlt low 5. Guntlt xll 7. Glov low 8. Glov xll ROM WRIST or XILL LT RM RIGHT RM 0 1½ Rt n zppr: Lnt ( not ull) orsl Plmr Ulnr Wt ook & loop zppr sp t Rl Slvs or rs, Suts, & Vsts 25. oy r 27. Sut Slv 29. Sut Slv 31. Vst 3 4½ xpnson pnl: Lt Rt (xpnson pnls r ull lnt y ult; ulnr wn slv sprt rom rso, plmr wn tt rso rmnt) Rr t Msurn Mnul slv plmr ov kn ors l ulnr rl or nkl slv XILL 1½" nrmnts WRIST Msur wt rm own 6 7½ 9 10½ 12 13½ Stump Msurmnt 15 STUMP LT RIGHT Stump ovr styl: Orn pl 16½ 18 19½ 21 u IO-ONPTS, IN., PHONIX, RIZON
8 LOWR XTRMITY usm Prssur Grmnts r vll only unr Pysn s Orr 12. Skn kn 18. L & Pnty 23. r 2 ls ov kn 13. Skn t 19. Two ls wst 26. oy Sut slvlss ov kn 14. Skn kn no oot 20. Two Ls prnny 27. oy Sut slv ov kn 15. Skn t no oot 21. r 16. Skn kn t 28. oy Sut slvlss or nkl 17. L & p wst 22. r & p l m-t 29. oy Sut slv or nkl STRT T X or Y LT LG RIGHT LG 0 1½ 3 4½ Zppr(s): Lt Rt Ltrl Ltrl Lnt ( not ull) & Lon: xpnson pnl: Lt Rt (ult lon s postror l) Suspnrs: tt Rmovl Opn pus los pus Ml Ml Hook & loop zppr sp t Hook & loop zppr sp t Wst ook & loop ts tt rso (N/) Rr t Msurn Mnul WIST STUMP MSURMNT Pont Y 1 1 Pont X 1½" nrmnts OL TO LOOR LT Stump ovr styl: rumrns & soul vnly sp twn n Pont X NOT: S t Msurn Mnul or mportnt normn on t ol loor msurmnt RIGHT Orn pl Us ts orm or ll rmnts rqurn msurmnts o t l(s). Us t OOT or ll msurmnts o t oot (nlun t l rumrn). 1 1 TORSO 6 7½ 9 10½ 12 13½ 15 16½ 18 19½ 21 22½ 24 25½ 27 28½ 30 31½ 33 u IO-ONPTS, IN., PHONIX, RIZON
9 OOT usm Prssur Grmnts r vll only unr Pysn s Orr or nl msurmnts ov t 4½ n rumrn us t LOWR XTRMITY HRT OOT MSURMNTS LT RIGHT 11. nklt t or: 12. Skn kn 19. Two ls wst 13. Skn t 20. Two Ls prnny 17. L & p wst 28. oy Sut slvlss or nkl 18. L & Pnty 29. oy Sut slv or nkl 4½ Zppr(s): Lt Rt Ltrl Ltrl Ml Ml xpnson pnl: Lt Rt (ult lon s postror l plntr oot) Rr t Msurn Mnul Hook & loop zppr sp t Hook & loop zppr sp t 3 1½ Sl Sot Opn STNR TOS Sl To: t ox s m rom t sm r s t rst o t rmnt. Sot To: t ox s m o sot lnn mtrl; tr s sm roun t oot jonn t t rst o t rmnt. Opn : skn ns t your lst rumrn. Us ts orm or ll rmnts rqurn oot msurmnts. Us t LOWR XTRMITY HRT or msurmnts o t l n lowr rso o not 1½ msur rumrn 1½ r 1½ TO IRUMRNS n OOT TRINGS r ONLY RQUIR or: 36. oot Glov 37. oot Guntlt 38. oot Mttn oot Glovs, Guntlts, n Mttns r splty tms (normlly tt otr lowr xtrmty rmnts), us only wn sprt nlosurs or t s r n. tt oot trn; us t OOT TRING GUI. Pont Y 36. oot Glov LT OOT RIGHT OOT Invul s: Opn 37. oot Guntlt SPILTY TOS los 38. oot Mttn u IO-ONPTS, IN., PHONIX, RIZON
10 OOT TRING GUI Unvrsty rv, Ponx, rzon, U.S VOI: / X: / x4.00 Pls o not sn n trn wut sl rw 3-n lon ln n ts ox I t oot lov or untlt s v opn tps, mrk t sr ns o t s on t trn wt t mrks. Tk on rumrn msurmnt or n wrt t n t pproprt ox on t oot Msurmnt rt. Rqur ONLY or oot Glovs, oot Guntlts, n oot Mttns (Itms 36, 37, & 38) u IO-ONPTS, IN., PHONIX, RIZON
11 STH P USTOM PRSSUR GRMNTS Us ts skt p rw or mrk t lons o spl nsrts, lnns, usstts, n otr usm turs tt nnot nt on t pproprt orr orm. sur us lk pn or pnl, n wrt s lly s possl. Us t lttr ponts o rrn rlt ts rwn your orr orms. ll n t ptnt nm n t t. Nm: : u IO-ONPTS, IN., PHONIX, RIZON
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