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Medi Custom Leg Order Form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
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Medi Custom Toe Cap Order Form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
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Jobst JoviPak Custom Leg Order Form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
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Jobst JoviPak Custom Arm Order Form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
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Jobst Relax Arm and Leg Order Form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
Jobst Relax Order Form
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Jobst Relax Arm Order Form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
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Jobst Confidence AG and AD order form
Custom garments are priced individually. Please call for more information you may also email or fax form over for pricing.
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TributeNight Pants with Foot Coverage – Custom
- Recommended for clients needing coverage from the toes to waist.
- Special modifications may need to be made depending on the client.
If ordering for a client over 250 lbs, please include current weight, mobility limitations and call to discuss options. - To order this custom product, please call us or click on the order form below. After having your physical therapist or medical provider fill out the form we will provide you pricing and place the order on your behalf.
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Solaris TributeNight Compression Pants
- Recommended for clients with normal flexibility and range of motion (Bilateral chaps are suggested for clients that require easier donning)
- Closely resembles running pants; Midline and lateral zippers are included on this garment, free of charge
- Please use two order forms for legs and indicate in the comments section zipper preference (proximal to distal or distal to proximal)
- To order this custom product, please call us or click on the order form below. After having your physical therapist or medical provider fill out the form we will provide you pricing and place the order on your behalf.
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TributeNight Thigh – Lower Quadrant Chap & Half Leg
- Appropriate for clients who have full involvement in one quadrant and partial involvement in the contralateral quadrant
- Please use two leg forms when ordering
To order this custom product, please call us or click on the order form below. After having your physical therapist or medical provider fill out the form we will provide you pricing and place the order on your behalf.
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TributeNight Vest & Lower Torso
- Combine TT-MH with TT-JG for full torso coverage
- Separate garments are easier to care for and provide clients with the option of wearing one or both at any given time depending on their nightly needs
- V-neck, Round neck, Scoop neck, or Turtle neck options available; Scoop neck is default option unless otherwise noted on the order form
To order this custom product, please call us or click on the order form below. After having your physical therapist or medical provider fill out the form we will provide you pricing and place the order on your behalf.
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TributeNight Body Suit (Vertical Style)
- Provides superior truncal coverage while remaining easy to don
- V-neck, Round neck, Scoop neck, or Turtle neck options available; Scoop neck is default option unless otherwise noted on the order form
- Detachable arms may be added for full upper body support
To order this custom product, please call us or click on the order form below. After having your physical therapist or medical provider fill out the form we will provide you pricing and place the order on your behalf.