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CUSTOM ACTAEMBRACE BACK ORDER FORM CPC CODE: E2617 CUSTOMER×PATIENT INFORMATION Date: P.O. Number: Company Name×ACCT #: Patient Name: Requested By: Patient Weight: Email: Patient Height: Ship To:

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What is custom acta-embrace back order?

Custom acta-embrace back order is a process for requesting items that are currently out of stock.

Who is required to file custom acta-embrace back order?

Retailers and wholesalers who need to restock items that are not currently available.

How to fill out custom acta-embrace back order?

You can fill out the custom acta-embrace back order form online or by contacting the supplier directly.

What is the purpose of custom acta-embrace back order?

The purpose is to ensure that retailers and wholesalers can order items that are not currently in stock.

What information must be reported on custom acta-embrace back order?

You must report the item SKU, quantity needed, contact information, and shipping address.

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