ActiLymph MTM Garment Measurement and Order Form
This file provides detailed instructions and an order form for ActiLymph Made To Measure flat knit hosiery. It includes measurement guidelines for legs and panty, necessary for patients with lymphoedema and chronic oedema. Additionally, it contains the order details and contact information for submission.
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How do I fill this out?
To fill out this form, follow the measurement instructions carefully to ensure accurate fitting. Begin by measuring the leg according to the provided guidelines. Then, complete the order form with the required details and submit it via the specified contact methods.
How to fill out the ActiLymph MTM Garment Measurement and Order Form?
1
Begin by measuring the leg as per the guidelines.
2
Fill in the leg measurement fields clearly.
3
Measure the panty section where applicable.
4
Complete the order form with pharmacy and patient details.
5
Submit the form via the specified email, fax, or post.
Who needs the ActiLymph MTM Garment Measurement and Order Form?
1
Pharmacists who need to order custom compression garments for patients with lymphoedema.
2
Clinicians looking to prescribe flat knit hosiery to patients with chronic oedema.
3
Patients requiring made-to-measure compression hosiery for better management of their condition.
4
Medical suppliers fulfilling orders for lymphoedema garments.
5
Healthcare providers responsible for measuring and ordering compression stockings.
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On PrintFriendly, you can easily edit this PDF to update measurements and order details. Our PDF editor allows you to make precise changes to ensure accuracy. Save your edits and download the updated form for submission.
1
Open the PDF on PrintFriendly.
2
Use the editor to input or update measurements.
3
Ensure all order details are correct.
4
Save your edits.
5
Download the updated form for submission.
What are the instructions for submitting this form?
Submit the completed form via the following contact methods: Email: sales@credenhill.co.uk, Fax: 0115 944 0437, Post: Credenhill Limited, 10 Cossall Industrial Estate, Ilkeston, Derbyshire, DE7 5UG. For any queries, you may also contact via Freephone: 0800 195 0650 or 0115 932 0144. Ensure all sections are accurately completed before submission to avoid any delays.
What are the important dates for this form in 2024 and 2025?
Currently, there are no specific important dates mentioned for this form in 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to provide a comprehensive guide and order mechanism for ActiLymph Made To Measure hosiery. It ensures that patients with lymphoedema and chronic oedema receive accurately measured and comfortable fitting garments. The form includes detailed instructions on how to take precise measurements and complete the order sections, which is crucial for healthcare providers and patients.
Tell me about this form and its components and fields line-by-line.
- 1. Leg Measurements: Fields for various points on the leg including the thigh, calf, and ankle, enabling precise garment fitting.
- 2. Panty Measurements: Sections to measure waist, hip, and other relevant lengths to ensure proper fitting for pantyhose styles.
- 3. Order Details: Sections for pharmacy or clinic name, contact information, and practitioner and patient details.
- 4. Garment Selection: Options to choose the type of garment, compression class, and additional features like toe style and silicone bands.
- 5. Submission Information: Instructions and contact details for submitting the completed form via email, fax, or post.
What happens if I fail to submit this form?
Failing to submit this form may result in delays or inability to receive the necessary custom compression garments.
- Incorrect Garment Fitting: Without submission, patients may not receive properly fitted garments, impacting their treatment.
- Order Processing Delays: Delays in submission can lead to longer processing times and delayed delivery.
- Unfulfilled Medical Needs: Patients may not receive the medical support required for their condition without the proper garments.
How do I know when to use this form?
- 1. Prescription by Healthcare Provider: When a clinician prescribes custom compression hosiery.
- 2. Pharmacy Orders: For pharmacies ordering garments on behalf of their customers.
- 3. Direct Patient Use: Patients measuring at home and submitting orders themselves.
- 4. Medical Supplier Fulfillment: For suppliers fulfilling custom garment orders based on the form.
- 5. Routine Check-Ups: During regular health evaluations for patients requiring updated measurements and new garments.
Frequently Asked Questions
How do I fill out the order form?
Follow the measurement guidelines provided, input the measurements, complete the order details and submit as instructed.
Can I edit this form on PrintFriendly?
Yes, you can easily edit the form using PrintFriendly's PDF editor.
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Use PrintFriendly's signature feature to add your signature to the document and save it.
Can I share the edited PDF?
Yes, you can share the edited PDF via email or obtain a shareable link on PrintFriendly.
What if I make a mistake on the form?
You can re-edit the document on PrintFriendly to correct any mistakes before submission.
How do I measure the leg accurately?
Follow the provided measurement instructions carefully to ensure accurate readings for each section.
What details do I need for the order form?
Ensure you complete the pharmacy or clinic details, practitioner and patient names, and measurement specifics.
How do I submit the completed order form?
Submit via email, fax, or post to the specified contact details on the form.
What garments are available to order?
You can order ActiLymph MTM Ease and Dura in various styles and compression classes.
What options are provided for the garment?
Choose options like closed or open toe, silicone bands, ankle pads, and more as per the form details.
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