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FAX TO: 1-360-692-5600! EMAIL TO: info benik.com THUMB! Thumb IP Circumference: (Give measurement (A) If checked)! ? Too Tight ? Too Loose! Thumb Length: (Indicate alteration to the nearest ? )! ?
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How to fill out hand-splint-order-form-115:

01
Start by entering your personal information in the designated fields. This may include your name, contact information, and any relevant identification numbers.
02
Provide details about the patient for whom the hand splint is being ordered. Include their name, age, medical history, and any specific requirements or measurements for the splint.
03
Indicate the type of hand splint required. Specify whether it is for the left or right hand, the specific condition or injury being treated, and any additional features needed (such as adjustable straps or padding).
04
If applicable, provide any special instructions or preferences for the hand splint. This may include specific materials, colors, or design preferences.
05
Include the name and contact information of the prescribing healthcare professional. This ensures that the order can be properly verified and processed.
06
Review the completed form for accuracy and completeness before submitting it. Double-check all the information provided to avoid any errors or missing details.

Who needs hand-splint-order-form-115:

01
Individuals who have suffered hand injuries, fractures, or sprains and require a hand splint for immobilization and support during the healing process.
02
Patients with chronic hand conditions or disabilities that necessitate the use of a hand splint for everyday activities and mobility.
03
Healthcare professionals who prescribe hand splints or manage patients requiring specialized hand splints as part of their treatment plan.
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hand-splint-order-form-115 is a form used to request a hand splint for medical purposes.
Healthcare providers, physicians, or therapists are required to file hand-splint-order-form-115 when requesting a hand splint for a patient.
hand-splint-order-form-115 should be filled out with the patient's information, description of the hand splint needed, and the healthcare provider's signature.
The purpose of hand-splint-order-form-115 is to formally request a hand splint for a patient's medical needs.
Information such as patient details, hand splint specifications, and healthcare provider's signature must be reported on hand-splint-order-form-115.
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