ÖSSUR Custom Brace Order Form Instructions
This file provides a comprehensive order form for ÖSSUR custom braces. It includes shipping information, measurement types, and patient data collection. Healthcare professionals can use this form to facilitate the order of customized orthopedic braces efficiently.
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How do I fill this out?
To fill out this form, begin by entering the required patient information, including their diagnosis and measurements. Next, select the appropriate shipping method and date the brace is needed. Lastly, ensure all sections are completed before submission.
How to fill out the ÖSSUR Custom Brace Order Form Instructions?
1
Collect all required patient information.
2
Choose the measurement type for the brace.
3
Select a shipping method and date.
4
Fill in billing and shipping addresses.
5
Review the form for completeness before submission.
Who needs the ÖSSUR Custom Brace Order Form Instructions?
1
Healthcare providers who prescribe orthopedic braces.
2
Patients needing custom-fit orthopedic solutions.
3
Physical therapists assisting with patient mobility solutions.
4
Insurance professionals documenting order requests.
5
Medical facility coordinators managing brace orders.
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1
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2
Select the 'Edit' option to enable editing mode.
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Make necessary changes to the form fields.
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After editing, review all changes to ensure accuracy.
5
Download the edited PDF to save your work.
What are the instructions for submitting this form?
To submit this form, email it to customerservice@pelservice.com or fax it to 800-222-6176. Ensure all fields are completed to avoid delays in processing. You may also send the completed form via physical mail to PEL LLC, 4666 Manufacturing Ave, Cleveland, OH 44135 for further assistance.
What are the important dates for this form in 2024 and 2025?
The form is effective immediately. Ensure submission timelines align with patient requirements. Special notices regarding deadlines for rush orders will be detailed on the form.
What is the purpose of this form?
The purpose of this form is to provide an efficient means for healthcare professionals to order custom orthopedic braces tailored to patient needs. By collecting comprehensive patient information alongside precise measurements, this form reduces errors and enhances the speed of processing orders. Ultimately, it streamlines the process for both practitioners and patients needing orthopedic solutions.
Tell me about this form and its components and fields line-by-line.
- 1. Patient Information: Includes patient's last name, first name, diagnosis, height, weight, age, sex, email, and contact information.
- 2. Shipping Information: Specifies shipping address, ship-to PO number, and contact details.
- 3. Measurement Type: Identifies the measurement types to be used for creating the custom brace.
- 4. Brace Specifications: Details the custom modifications and options required for the brace.
- 5. Additional Instructions: Provides space to include any special instructions or requirements for the order.
What happens if I fail to submit this form?
If the form is not submitted correctly, there may be a delay in processing the brace order. It could lead to the patient not receiving their necessary equipment on time.
- Incorrect Measurements: Incorrect measurements can lead to ill-fitting braces, requiring additional adjustments.
- Missed Deadlines: Late submissions may result in braces not being ready by the needed date.
- Incomplete Information: Failing to complete all sections can cause processing errors and delays.
How do I know when to use this form?
- 1. Post-Surgery Recovery: Ideal for patients recovering from knee or joint surgeries needing support.
- 2. Chronic Condition Management: Used for managing conditions like osteoarthritis where custom support is essential.
- 3. Sports Injury Rehabilitation: Helps athletes recover from injuries by providing tailored orthopedic solutions.
- 4. Accident Recovery: Necessary for individuals recovering from accidents requiring custom brace support.
- 5. Pediatric Needs: Creates braces specifically for children with varying medical needs.
Frequently Asked Questions
How do I fill out the order form?
Start by providing patient information and measurements, select a shipping option, and ensure all sections are completed.
Can I edit the PDF before submitting?
Yes, you can edit the PDF using PrintFriendly's editing tools for any necessary adjustments.
How do I submit the completed form?
Submit the form via email or fax to the provided contact information on the form.
Is there a deadline for submission?
Ensure all orders are completed and submitted at least a week before the required date of the brace.
What if the information is incorrect?
Make sure to review the form carefully before submission to avoid any mistakes.
Can I share the form with others?
Absolutely! Use the share feature in PrintFriendly to send the document easily.
What if I need a custom design?
Custom modification requests can be included in the comments section of the form.
How do I access customer support?
You can reach customer support through the contact information provided in the form.
Can I download the form as a PDF?
Yes, after filling out the form, you can download it as a PDF file.
Is there an option for expedited processing?
Yes, select the rush option on the form for expedited processing.
