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Custom Measurement Form for Flat Knit Arm Sleeves Phone: 1 800 2224999 Fax: 1 800 6452519 www.juzousa.com Account Information Account Number Date Account Name Contact Phone Fax Patient ID PO Number
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How to fill out juzo arm sleeve measurement
How to fill out juzo custom order form:
01
Start by entering your personal information, such as your name, address, and contact details.
02
Indicate the type of garment you are ordering, whether it's a compression sleeve, stocking, or another product.
03
Specify the measurements required for the garment, such as the circumference of your arm or leg at various points.
04
Choose the desired compression level for the garment, whether it's light, medium, or firm compression.
05
Provide any additional details or special instructions for the order, such as specific colors or patterns.
06
Review the information you have entered to ensure accuracy.
07
Complete the payment section with your preferred payment method and provide any necessary billing information.
08
Finally, submit the completed form either by mailing it to the designated address or submitting it online through the Juzo website.
Who needs juzo custom order form:
01
Individuals who require compression garments to manage conditions such as lymphedema, edema, or varicose veins.
02
People who have specific measurement or fitting requirements that cannot be met by standard-sized compression garments.
03
Those who prefer customized compression garments tailored to their unique needs and preferences.
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What is juzo custom order form?
The Juzo custom order form is a specialized document used to place custom orders for Juzo medical garments, ensuring proper fit and specifications tailored to individual patient needs.
Who is required to file juzo custom order form?
The Juzo custom order form must be filed by healthcare providers or suppliers on behalf of patients who require custom-made medical garments due to specific medical conditions or fitting requirements.
How to fill out juzo custom order form?
To fill out the Juzo custom order form, practitioners need to input patient details, select the appropriate product type, specify measurements, and include any required medical documentation or insurance information.
What is the purpose of juzo custom order form?
The purpose of the Juzo custom order form is to facilitate the accurate processing of custom garment orders, ensuring that patients receive the correct products that meet their individualized medical and therapeutic needs.
What information must be reported on juzo custom order form?
The information required on the Juzo custom order form typically includes patient demographics, product selection, precise measurements, physician's details, diagnosis codes, and any additional instructions relevant to the custom order.
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