2012 order forms & sizing guides - brightlife direct · pdf filecustom juxta-fit™...

2012 Order FOrms & sizing guides rev. 05

CircAid® General Order Form

Juxta-Lite™ Single Patient Order Form

Juxta-Lite™ Volume Stock Order Form

Juxta-Fit™ Premium & Essentials / Classic-Flex™ /Ready-Fit™ Single Patient Order Form

Juxta-Fit™ Armsleeve Single Patient Order Form

Comfort Ancillaries™ Order Form

CircPlus™ Volume Stock Order Form

Juxta-CURES™ Volume Stock Order Form

Custom Garment Order Form and Instructions

Custom Legging Sizing Chart

Custom Armsleeve Sizing Chart

Package Contents

Terms and Conditions

2

3

4

5

6

7

8

9

10

11

12

13

14

Table of Contents

2012 Order FOrms & sizing guides1

FACILITY NAME CONTACT NAME FORM OF PAYMENT

DATE PHONE FAX

Card Number:

EMAIL ADDRESS Card Holder’s Name:

Expiration Date:

BILLING ADDRESS ACCOUNT NUMBER2 PURCHASE ORDER NUMBER

SHIPPING METHOD3

SHIPPING ADDRESS (IF DIFFERENT FROM ABOVE) r Ground r 3 Day r 2 Day

r Next Day Saver r Next Day(Early AM)

r Next Day(10:30AM)

ITEM NUMBER ITEM DESCRIPTION SIZE QUANTITY

CIRCAID MEDICAL PRODUCTS | C- OF-020612-01

1 Completed custom orders are processed within five business days.2 For new accounts, an account setup form or credit application must be completed, the form is available for download at www.circaid.com. Credit process can take from 2-3 weeks to complete.3 Shipping options vary by location.

order form2


r COD r Purchase Order

DATE PHONE FAX r American Express r VISA r MasterCard

Card Number:


Expiration Date:


PATIENT NAME FACILITY REFERENCE

SHIPPING ADDRESS (IF DIFFERENT FROM ABOVE) SHIPPING METHOD3

r Ground r 3 Day r 2 Day

r Next Day Saver r Next Day (Early AM) r Next Day (10:30AM)

measuremenTs

leFT righT

B

C

h

d

lengTh measuremenT

size d

shOrTunder 44cm

lOngover

44cm

CirCumFerenCe measuremenTs

sizelegging

B Csmall 19-22cm 26-36cm

medium 22-27cm 33-44cm

medium FULL CALF 22-27cm 44-54cm

large 25-32cm 41-51cm

large FULL CALF 25-32cm 51-61cm

xl 30-37cm 37-48cm

xl FULL CALF 30-37cm 48-61cm

xxl 35-42cm 53-64cm

leFT righT

lengTh size lengTh size

r LONG r SHORT

r LONG r SHORT

qTy: qTy:

COmFOrT silVer leg liner™ uPgrade (ONE LINER)

qTy:

FOOT OPTiOns qTy:

JuxTa-liTe™ aFW SMALL

JuxTa-liTe™ aFW MEDIUM

COmFOrT ez single-Band aFW™ 3"(7.6cm) WIDE

COmFOrT ez single-Band aFW™ 4”(10.2cm ) WIDE

addiTiOnal anCillaries size qTy

COMFORT COVERUP™ FOR LOWER LEG (BLACk) (SMALL: 34cm - 50cm) (LARGE: 51cm - 80cm)

COMFORT COVERUP™ FOR LOWER LEG (BEIGE)(SMALL: 34cm - 50cm) (LARGE: 51cm - 80cm)

COMFORT CAPRI™ (FOR THE SIZING CHART VISIT www.CIRCAID.COM)

PAIR OF COMFORT COMPRESSION ANkLETS™

PAIR OF COMFORT LEG LINERS™ (FOOTLESS) n/a

PAIR OF COMFORT SILVER LEG LINERS™ (FOOTLESS) n/a

PAIR OF COMFORT kNEE-HIGH SOCkS™ n/a

PAIR OF COMFORT THIGH-HIGH SOCkS™ n/a

PAIR OF COMFORT COTTON TERRy kNEE-HIGH SOCkS™ n/a

PAIR OF COMFORT COTTON TERRy THIGH-HIGH SOCkS™ n/a

PAIR OF COMFORT SILVER kNEE-HIGH SOCkS™ n/a

PAIR OF COMFORT SILVER THIGH-HIGH SOCkS™ n/a

INSTRUCTIONAL DVD n/a

aFW measuremenT

size h

small 19-26cm

medium 24-31cm

JL-OF-052512-01CIRCAID MEDICAL PRODUCTS | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123

NOTE: The maximum limb circumference for the Juxta-Lite™ legging is 64cm. If your patient exceeds this measurement, a

custom Juxta-Fit™ legging is available for order.

The maximum foot arch circumference for the Juxta-Lite™ Ankle-Foot Wrap is 31cm. The Comfort Compression Anklet™ maximum foot arch circumference is 36cm for Standard and 41cm for Large, and the maximum ankle circumference is 27cm for Standard and 50cm for Large. If your patient exceeds these measurements, the Comfort EZ Single-Band Ankle-Foot Wrap™ is available for order.

The maximum limb circumference for the:• Comfort knee-High Sock™ and Comfort Leg Liner™ is 64cm• Comfort knee-High Cotton-Terry Sock™ is 91cm• Comfort knee-High Silver Sock™ and Comfort Silver Leg Liner™ is 71cm

Patient should be standing when taking measurements. Limbs should be at their smallest; limb size should be maintained from time of measurements to ensure a proper fit of the garment. Be sure to select a length (D) and a legging size (B, C). Also, select a foot size (H) if ordering a detached Juxta-Lite™ Ankle-Foot Wrap (AFW). After measuring the smallest dimension of the ankle and the largest dimension of the calf, if the measurements do not fall within one of these size ranges, call (800) 247-2243. Actual legging lengths are 28cm (Short) and 33cm (Long). Note: Standard offering includes one legging, one BPS™ card, one Comfort Leg Liner™ and one pair of Comfort Compression Anklets™. The Comfort Leg Liner™ can be upgraded to a Comfort Silver Leg Liner™ for an additional cost at the time of purchase. note 1in = 2.54cm

Terms and Conditions: F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark and Comfort CoverUp, Juxta-Lite, Comfort Capri, Comfort Leg Liner, Comfort Silver Leg Liner, Comfort knee-High Sock, Comfort Thigh-High Sock, Comfort Silver knee-High Sock, Comfort Silver Thigh-High Sock, Comfort Cotton Terry knee-High Sock, Comfort Cotton Terry Thigh-High Sock, Comfort Compression Anklets, Comfort knee-High Stockinette, Comfort EZ Single-Band Ankle-Foot Wrap, and BPS are trademarks of CircAid Medical Products, Inc. ©2012 CircAid Medical Products, Inc. All rights reserved. PRICES SUBJECT TO CHANGE WITHOUT NOTICE.

1 Same day shipping to accounts in good standing for standard orders.2 For new accounts, an account setup form or credit application must be completed. The form is available for download at www.circaid.com.3 Shipping options vary by locat

EMAIL ORDER: by 12:00PM PST1

d

B

C

h

order formS I N G L e P A T I e N T

s i z i n g c h a r t

3

size a size B size C size d size e

size F size g size h size i size J

addiTiOnal anCillaries (Write in the quantities of each product for the respective size)

One size sTandard small medium medium

FuLL CALF large large FuLL CALF xl xl

FuLL CALF xxl

JuxTa-liTe™ INSTRUCTIONAL DVD

COmFOrT COmPressiOn anKleTs™ (PAIR) (Buy 10 pairs and get 2 pairs free)

COmFOrT ez single-Band anKle-FOOT WraP™ 3” WIDE (Discounted when ordered in pairs, see pricelist for more info)

COmFOrT ez single-Band anKle-FOOT WraP™ 4” WIDE (Discounted when ordered in pairs, see pricelist for more info)

JuxTa-liTe™ anKle-FOOT WraP

COmFOrT COVeruP™ FOR LOWER LEG (BLACk)

COmFOrT COVeruP™ FOR LOWER LEG (BEIGE)

COmFOrT leg liners™ (FOOTLESS PAIR)(Buy 10 pairs and get 2 pairs free)

COmFOrT Knee-high sOCKs™ (PAIR)(Buy 10 pairs and get 2 pairs free)

COmFOrT COTTOn Terry Knee-high sOCKs™ (PAIR)(Buy 10 pairs and get 2 pairs free)

COmFOrT silVer Knee-high sOCKs™ (PAIR)(Buy 10 pairs and get 2 pairs free)

COmFOrT silVer leg liners™ (PAIR)(Buy 10 pairs and get 2 pairs free)

COmFOrT CaPri™

PrOduCT seleCTiOn(Write in the quantities of each product for the respective size)

small medium medium FuLL CALF large large

FuLL CALF xl xl FuLL CALF xxl

JuxTa-liTe™ SHORT LEGGING WITH ANkLETS (28CM)


JuxTa-liTe™ LONG LEGGING WITH ANkLETS (33CM)





Card Number:


Expiration Date:


SHIPPING METHOD3



CIRCAID MEDICAL PRODUCTS, INC. | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123 | JL-BO -050212-02

CHOOSE THE PERFECT ALTERNATIVE

1 Same day shipping to accounts in good standing for standard orders.2 For new accounts, an account setup form or credit application must be completed. The form is available for download at www.circaid.com.3 Shipping options vary by location.

Terms and Conditions F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark and Juxta-Lite, Comfort Compression Anklets, Comfort CoverUp, Comfort Capri, Comfort Leg Liner, Comfort Silver Leg Liner, Comfort knee-High Sock, Comfort Silver knee-High Sock, Comfort Cotton Terry knee-High Sock, Comfort EZ Single-Band Ankle-Foot Wrap are trademarks of CircAid Medical Products, Inc. ©2012 CircAid Medical Products, Inc. All rights reserved. PRICES SUBJECT TO CHANGE WITHOUT NOTICE.


order formV o L U m e S T o C K

4




Card Number:


Expiration Date:






measuremenTs

leFT righT

B

B1

C

h

B-d

JuxTa-FiT™ Premium & essenTials

sizeCirCumFerenCe measuremenT

B B1 Csmall 15-23cm 20-28cm 30-38cm

medium 20-28cm 25-33cm 36-43cm

medium FULL CALF 20-28cm 33-40cm 43-50cm

large 25-33cm 30-38cm 41-48cm

large FULL CALF 25-33cm 38-46cm 48-56cm

xl 30-38cm 33-41cm 41-51cm

xl FULL CALF 30-38cm 41-51cm 51-61cm

xxl* 33-41cm 43-53cm 53-64cm

FOOT OPTiOns size: qTy:

Comfort Compression Anklets™ (Standard max circumference H = 36cm B = 27cm) (Large max circumference H = 41cm B = 50cm)

Comfort EZ Single-Band Ankle-Foot Wrap™ (3”) n/a

Comfort EZ Single-Band Ankle-Foot Wrap™ (4”) n/a

Standard Juxta-Fit™ Ankle-Foot Wrap (max H circumference 34cm)

Standard Juxta-Fit™ Interlocking Ankle-Foot Wrap (max H circ. 34cm)

Custom Juxta-Fit™ Interlocking Ankle-Foot Wrap

Juxta-Lite™ Ankle-Foot Wrap (max H circumference 31cm) §

aFW measuremenTsize h

small 19-24cm

medium 24-29cm

large 29-34cm

ClassiC-Flex™ & ready-FiT™

sizeCirCumFerenCe measuremenT

B B1 Csmall 15-23cm 20-28cm 30-38cm

medium 20-28cm 25-33cm 36-43cm

large 25-33cm 30-38cm 41-48cm

xl 30-38cm 36-46cm 46-56cm

xxl 33-41cm 43-53cm 53-64cm

anCillaries size: qTy:

COMFORT COVERUP™ FOR LOWER LEG (BLACk) (Small: 34cm - 50cm)

COMFORT COVERUP™ FOR LOWER LEG (BLACk) (Large: 51cm - 80cm)

COMFORT COVERUP™ FOR LOWER LEG (BEIGE) (Small: 34cm - 50cm)

COMFORT COVERUP™ FOR LOWER LEG (BEIGE) (Large: 51cm - 80cm)

COMFORT CAPRI™ (For a sizing chart visit www.circaid.com)

INSTRUCTIONAL DVD

legging OPTiOns size: qTy:

28Cm JuxTa-FiT™ Premium †

sTandard lOWer legging (SHORT)

36Cm JuxTa-FiT™ Premium †

sTandard lOWer legging (LONG)

28Cm JuxTa-FiT™ essenTials †

sTandard lOWer legging (SHORT)

36Cm JuxTa-FiT™ essenTials †

sTandard lOWer legging (LONG)

ready-FiT™ sTandard lOWer legging ‡

ClassiC-Flex™ sTandard lOWer legging ‡

lengTh measuremenT

size B-dshOrT under

36cm

lOng over 36cm

Premium & essenTials ready-fit™cLassic-fLeX™

JF-OF-050212-02CIRCAID MEDICAL PRODUCTS | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123

Terms and Conditions F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark, Juxta-Fit, Juxta-Lite, Classic-Flex and Ready-Fit are trademarks of CircAid Medical Products, Inc. ©2012 CircAid Medical Products, Inc. All rights reserved.

* If measurements fall within XXL size range, please consider ordering a custom Juxta-Fit™ for optimal fit.

‡ EZ Single-Band Ankle-Foot Wrap™ included by default§ Juxta-Lite™ Ankle-Foot Wrap is available only in sizes

Small and Medium† Comfort Compression Anklets™ included by default

E MAIL ORDER: by 12:00PM PST1

Patient should be standing when taking measurements. Limbs should be at their smallest; limb size should be maintained from time of measurements to ensure a proper fit of garment. When on borderline between sizes, select a smaller size if significant edema is present and reduction is anticipated; if edema is minimal, select larger size. After measuring the smallest dimension of the ankle and the largest dimension of the calf, if any of the measurements do not fall within one of these size ranges, call (800) 247-2243. Length measurement is for Juxta-Fit™ only, actual legging lengths are 28cm (Short) and 36cm (Long); Ready-Fit™ and Classic-Flex™ have one adjustable length. note 1in = 2.54cm


PRICES SUBJECT TO CHANGE WITHOUT NOTICE.

B-d

B

C

h

B1

25 cm above malleolus




s i z i n g c h a r t

5




Card Number:


Expiration Date:






ARM CIRCUMFERENCEMEASUREMENTS

(Palm; wrist; 5cm increments from the wrist to the axilla)

MEASURING POINTS

Palm

Wrist

5cm

10cm

15cm

20cm

25cm

30cm

35cm

40cm

45cm

50cm

55cm

ARM LENGTH

c-e c-g

wrist to elbow crease

wrist to axilla (or where the

garment should end)

ARM AND HAND SELECTION

r RIGHT r LEFT

JuxTa-FiT™ GLOVE MEASUREMENTS

lengTh1 2 3 4 5 6 7 8 9 10

CirCumFerenCe

1x 2x 3x 4x 5x a b c

1w 2w 3w 4w 5w

JuxTa-FiT™ GAUNTLET SIZE OPTIONS

Palm CirCumFerenCe 14-17cm 17-20cm 20-23cm 23-26cm 26-29cm

size r XSMALL r SMALL r MEDIUM r LARGE r XL

HAnd OPTiOns

r GAUNTLET

r GLOVE

r DORSUMSTRAP

r NONE

COveruP COLOr

r BLACK

r BEIGE

r PINK

ARMSLEEVE

CIRCAID MEDICAL PRODUCTS | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123 JFA- OF-020712-01

Fax Order: EMAIL ORDER: by 12:00PM PST1

MEASUREMENTS 1x-5x: the circumference of each finger at the Proximal Interphalangeal joint (PIP) or if the base of the finger is larger than the PIP please use the larger measurement.

MEASUREMENT b:circumference of palm at base of thumb webbing

MEASUREMENT a:circumference of palm at base of pinky finger

MEASUREMENTS 1w-5w: the circumference where the glove should end; commonly, the Distal Interphalangeal joint (DIP).

MEASUREMENT c: circumference of the wrist

MEASUREMENTS 1-5: length of finger from the center of the crease at base to where the glove should end

MEASUREMENT 8: length from the crease between the ring finger and pinky finger to the base of the palm

MEASUREMENT 10: width of palm at base of pinky finger

MEASUREMENT 9: width of palm at base of thumb webbing

MEASUREMENT 6: length from base of index finger to the base of thumb webbing

MEASUREMENT 7: length from base of index finger (same as 6) to base of palm

The Juxta-Fit™ Armsleeve is constructed from the wrist to the axilla measurement. A lateral rise is incorporated at the top of the garment in addition to a 10° bend is at the elbow. Measure patient’s arm length with the arm bent at 35°. Also ensure that the arm is at its smallest and maintain arm size at time of measuring to assure a proper fit of the garment(s). nOTe: 1in = 2.54cm

1 Completed custom orders are processed within five business days.2 For new accounts, an account setup form or credit application must be completed. The form is available for download at www.circaid.com. Credit process can take from 2-3 weeks to complete.3 Shipping options vary by location.

Terms and Conditions: F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark and Juxta-Fit is a trademark of CircAid Medical Products, Inc. ©2011 CircAid Medical Products, Inc. All rights reserved.

1w

2x3x

4x

5x

b

a

2w

3w

4w

5w

1x

c

c-e

c-g

16

2

3

4

5

8

9

10

7


6




Card Number:


Expiration Date:


SHIPPING METHOD3



CaPri sizing

size WaisT (T)CirCumFerenCe

Thigh (g)largesT

CirCumFerenCe

a 63cm - 79cm 46cm - 62cm

B 67cm - 85cm 49cm - 65cm

C 72cm - 91cm 52cm - 70cm

d 76cm - 96cm 55cm - 73cm

e 81cm - 102cm 60cm - 81cm

F 85cm - 108cm 63cm - 84cm

g 90cm - 113cm 67cm - 90cm

h 94cm - 119cm 70cm - 93cm

i 99cm - 125cm 72cm - 96cm

J 103cm - 130cm 77cm - 102cm

COmFOrT COVeruP™ sizing

CirCumFerenCe measuremenTs small large

Comfort CoverUp™ Below knee 34cm -50cm 51cm -80cm

Comfort CoverUp™ Whole Leg 50cm - 71cm 72cm - 108cm

Comfort CoverUp™ Arm 26cm - 39cm 40cm - 60cm

Note: Take measurements while wearing your compression garment to ensure the best fit. A custom Comfort CoverUp™ is available for those who do not fit in the above size ranges.

anCillaries size quanTiTy

COMFORT COMPRESSION ANkLETS™ †

STANDARD: max arch circumference 36cm; max ankle circumference 27cmLARGE: max arch circumference 41cm; max ankle circumference 50cm

ARMSLEEVE COMFORT COVERUP™ (BEIGE)

ARMSLEEVE COMFORT COVERUP™ (BLACk)

ARMSLEEVE COMFORT COVERUP™ (PINk)

LOWER LEG COMFORT COVERUP™ (BEIGE)

LOWER LEG COMFORT COVERUP™ (BLACk)

WHOLE LEG COMFORT COVERUP™ (BEIGE)

WHOLE LEG COMFORT COVERUP™ (BLACk)

anCillaries One-size

COMFORT NON-SLIP LINER™ 18”X30”*

COMFORT NON-SLIP LINER™ 18”X60”*

COMFORT EZ SINGLE-BAND ANkLE-FOOT WRAP™ (3” WIDE)‡

COMFORT EZ SINGLE-BAND ANkLE-FOOT WRAP™ (4” WIDE)‡

COMFORT COTTON TERRy kNEE-HIGH SOCkS™ maximum limb circumference: 91cm†

COMFORT COTTON TERRy THIGH-HIGH SOCkS™ maximum limb circumference: 91cm†

COMFORT ARM LINER™ (WITH THUMBHOLE) maximum limb circumference: 54cm

COMFORT LEG LINER™ (FOOTLESS) maximum limb circumference: 64cm†

COMFORT kNEE-HIGH SOCkS™ maximum limb circumference: 64cm†

COMFORT THIGH-HIGH SOCkS™ maximum limb circumference: 79cm†

COMFORT SILVER ARM LINER™ (WITH THUMBHOLE) maximum limb circumference: 54cm

COMFORT SILVER LEG LINER™ (FOOTLESS) maximum limb circumference: 71cm†

COMFORT SILVER kNEE-HIGH SOCkS™ maximum limb circumference: 71cm†

COMFORT SILVER THIGH-HIGH SOCkS™ maximum limb circumference: 71cm†

COMFORT ARM STOCkINETTE™ (SINGLE PLy) maximum limb circumference: 56cm†

COMFORT THIGH-HIGH STOCkINETTE™ (SINGLE PLy) maximum limb circumference: 100cm†

COMFORT kNEE-HIGH STOCkINETTE™ (DOUBLE PLy) maximum limb circumference: 66cm†

COMFORT THIGH-HIGH STOCkINETTE™ (DOUBLE PLy) maximum limb circumference: 100cm†

COMFORT CAPRI™

size a size B size C size d size e

size F size g size h size i size J

CIRCAID MEDICAL PRODUCTS | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123 C- OF-050212-02

anCillaries

Terms and Conditions: F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark and Comfort Capri, Comfort Non-Slip Liner, Comfort CoverUp, Comfort Cotton Terry knee-High Sock, Comfort Cotton Terry Thigh-High Sock, Comfort Arm Liner, Comfort Leg Liner, Comfort knee-High Sock, Comfort Thigh-High Sock, Comfort Silver Arm Liner, Comfort Silver knee-High Sock, Comfort Silver Thigh-High Sock, Comfort Arm Stockinette, Comfort Thigh-High Stockinette and Comfort knee-High Stockinette are trademarks of CircAid Medical Products, Inc. ©2012 CircAid Medical Products, Inc. All rights reserved. PRICES SUBJECT TO CHANGE WITHOUT NOTICE.


When taking measurements, measure at the largest circumference point. When selecting a size, choose the smallest size match for the most snug fit. Choose the largest size match for a more relaxed, easy to wear to fit.


disCOunTs:*Buy 4 or more Comfort Non-Slip Liners™ and get 50% off.† Buy 10 pairs and get 2 free.‡Discounted when ordered in pairs, see your pricelist for more information.

g

T

order form7




Card Number:


Expiration Date:


SHIPPING METHOD3



CirCumFerenCe measuremenTsinChes CenTimeTers

quanTiTy size WAIST (T)

ANkLE (H)

WAIST (T)

ANkLE (H)

a 25 - 31 7 - 8 63 - 79 18 - 20

B 26 - 33 7 - 8 67 - 85 18 - 20

C 28 - 36 8 - 9.5 72 - 91 21 - 24

d 30 - 38 8 - 9.5 76 - 96 21 - 24

e 32 - 40 8 - 9.5 81 - 102 21 - 24

F 33 - 43 9.5 - 11 85 - 108 25 - 28

g 35 - 44 9.5 - 11 90 - 113 25 - 28

h 37 - 47 9.5 - 11 94 - 119 25 - 28

i 39 - 49 9.5 - 11 99 - 125 25 - 28

J 41 - 51 9.5 - 11 103 - 130 25 - 28

CIRCAID MEDICAL PRODUCTS | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123 | CP-VSOF-110111-01

VEIN PROCEDURE COMPRESSION SySTEM

Terms and Conditions: F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark and CircPlus is a trademark of CircAid Medical Products, Inc. ©2011 CircAid Medical Products, Inc. All rights reserved.



1 Same day shipping to accounts in good standing for standard orders.2 For new accounts, an account setup form or credit application must be completed, the form is available for download at www.circaid.com.3 Shipping options vary by location.

Patient should be standing when taking measurements. Limbs should be at their smallest; limb size should be maintained from time of measurements to assure a proper fit of garment. When measurements fall into multiple sizes, choose the capri size where the waist measurement is in the middle of the range. After measuring the smallest dimension of the ankle and the smallest dimension of the waist, if any of the measurements do not fall within one of these size ranges, call Customer Service at (800) CIRCAID (247-2243).

T

hANkLE CIRCUMFERENCE AT THE SMALLEST DIMENSION

WAIST CIRCUMFERENCE AT THE SMALLEST DIMENSION

order formV o L U m e S T o C K

8




Card Number:


Expiration Date:





PrOduCT seleCTiOn qTy

Juxta-Cures™ (Short 28cm) - 5 Pack of Short Leggings

Juxta-Cures™ (Standard 33cm) - 5 Pack of Standard Leggings

Juxta-Cures™ (Long 38cm) - 5 Pack of Long Leggings

Juxta-Cures™ (Trial) - 4 Pack of 2 Short Leggings and 2 Standard Leggings

addiTiOnal anCillaries qTy

Comfort ez single-Band ankle-Foot Wrap™ 3” Wide (Discounted when ordered in pairs, see pricelist for more info)

Comfort ez single-Band ankle-Foot Wrap™ 4” Wide (Discounted when ordered in pairs, see pricelist for more info)

Comfort Compression anklets™ (Standard Pair) - Buy 10 pairs and get 2 pairs free! maximum arch circumference 36cm; maximum ankle circumference 27cm

Comfort Compression anklets™ (Large Pair) - Buy 10 pairs and get 2 pairs free! maximum arch circumference 41cm; maximum ankle circumference 50cm

Comfort leg liners™ (Footless Pair) - Buy 10 pairs and get 2 pairs free!

Comfort silver leg liners™ (Footless Pair) - Buy 10 pairs and get 2 pairs free!

Comfort Knee-high socks™ (Pair) - Buy 10 pairs and get 2 pairs free!

Comfort Cotton Terry Knee-high socks™ (Pair) - Buy 10 pairs and get 2 pairs free!

Comfort silver Knee-high socks™ (Pair) - Buy 10 pairs and get 2 pairs free!

CIRCAID MEDICAL PRODUCTS, INC. | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123 JC-BO -050212-02


Terms and ConditionsF.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card payment. Visa, MasterCard, and American Express accepted. Please request a Credit Application from Customer Service for establishing an Account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank. CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a registered trademark. Juxta-CURES, Compression Ulcer Recovery System, Comfort Compression Anklet, Comfort Leg Liner, Comfort Silver Leg Liner, Comfort knee-High Sock, Comfort Silver knee-High Sock, Comfort Cotton Terry knee-High Sock, and Comfort EZ Single-Band Ankle-Foot Wrap are trademarks of CircAid Medical Products, Inc. ©2012 CircAid Medical Products, Inc. All rights reserved.



order formV o L U m e S T o C K9

iTem numBer iTem desCriPTiOn size quanTiTy

FaCiliTy name COnTaCT name FOrm OF PaymenT


daTe PhOne Fax r American Express r VISA r MasterCard

Card Number:

email address Card Holder’s Name:

Expiration Date:

Billing address aCCOunT numBer2 PurChase Order numBer

PaTienT name FaCiliTy reFerenCe




CIRCAID MEDICAL PRODUCTS | 9323 CHESAPEAkE DRIVE, SUITE B2, SAN DIEGO, CA 92123 | C A-OF-091211-01

insTruCTiOns FOr CusTOm Orders

1. Patient: a) should be measured when limb is at its smallest; b) should be in standing position, if possible; c) limb size should be maintained at time of measuring to assure a proper fit.

2. Patient can reach ankles, or will have assistance in applying the garment and adjusting the straps throughout the day. r yes r No (If no, patient is not a good candidate for the garment).

3. Include the corresponding custom armsleeve or custom legging sizing chart(s) with your order form (page 11 or 12).

4. Facility and patient acknowledge that custom-made products are warranted to be free of defects in materials and workmanship and can be returned for alterations and repairs only (alteration fee, based on garment and alteration requested, will apply). r yes r No

5. ACkNOWLEDGEMENT: For Whole Legging, Upper Legging, Upper Legging w/knee, knee Piece and Lower Legging w/knee, if the garment is not used as directed, it may slip during daytime use. r N/A r yes

6. Prior to finalizing Graduate orders, please send the following sample: r N/A r No: Patient is familiar with the garment or this is a reorder r yes: Please send a Graduate sample

7. Patient has uncommon shape, skin folds, tissue mass/shelves, or any other conditions out of the ordinary as described in detail below (provide circumference measurements of leg above and below shelf, size of mass, location on limb, etc). r Posterior, anterior, medial, and lateral pictures of limb, including foot forthcoming (DO NOT FAX. Send images via email to [email protected] and specify in the subject line: Pics / facility name & patient’s first name and last initial; or send via USPS Mail).r N/A

8. A thick, cotton terry sock is available at no additional cost if the patient’s skin is compromised and additional cushioning is needed. Be sure to request this sock when you send in your order by product #RSOCT001 (knee-high) or #RSOCT002 (thigh-high).

1 Completed custom orders are processed within five business days.2 For new accounts, an account setup form or credit application must be completed. The form is available for download at www.circaid.com. Credit process can take 2-3 weeks to complete.3 Shipping options vary by locat

o r d e r f o r mC U S T o m G A r m e N T

10

<36cm Short

>36cm Long

DATE PATIENT NAME FACILITY NAME CONTACT REORDER

r yes r No

PRODUCT SELECTIONr 28cm Juxta-Fit™ Premium Standard Lower Legging (Short)§

r 36cm Juxta-Fit™ Premium Standard Lower Legging (Long) §

r 28cm Juxta-Fit™ Essentials Standard Lower Legging (Short) §

r 36cm Juxta-Fit™ Essentials Standard Lower Legging (Long) §

r Juxta-Fit™ Custom Lower Legging (only)‡

r Juxta-Fit™ Custom knee Piece (only)

r Juxta-Fit™ Custom Upper Legging (only)

r Juxta-Fit™ Custom Lower Legging w/knee‡

r Juxta-Fit™ Custom Upper Legging w/knee

r Juxta-Fit™ Whole Legging (please choose CoverUp color below)

r BLACk r BEIGE

r Classic Flex™ Custom Lower Legging

r Graduate™ Whole Leg (please choose CoverUp color below) r BLACk r BEIGE

r Graduate™ Bk

r Graduate™ Boot Only

SELECT FOOT OPTION‡

r Comfort Compression Anklet™ Standard (max H circumference 36cm; max B circumference 27cm)

r Comfort Compression Anklet™ Large (max H circumference 41cm; max B circumference 50cm)

r Comfort EZ Single-Band Ankle-Foot Wrap™ (3”)

r Comfort EZ Single-Band Ankle-Foot Wrap™ (4”)

r Standard Juxta-Fit™ Ankle-Foot Wrap (max H circumference 34cm)

r Standard Juxta-Fit™ Interlocking Ankle-Foot Wrap (max H circ. 34cm)

r Custom Juxta-Fit™ Ankle-Foot Wrap r ATTACHED r SEPARATE

r Juxta-Lite™ Ankle-Foot Wrap (max H circumference 31cm)

CIRCUMFERENCEMEASUREMENTS

LANDMARK MEASURING

POINTS

LEFT RIGHT

e circumference at center of patella*

B ankle circumference

around malleoli

5cm

10cm

15cm

20cm

25cm

30cm

35cm

40cm

45cm

50cm

55cm

60cm

65cm

70cm

75cm

80cm

85cm

small medium medium Full Calf large large Full Calf xl xl Full Calf xxl

15-23cm 20-28cm 20-28cm 25-33cm 25-33cm 30-38cm 30-38cm 33-41cm



LENGTH MEASUREMENTS

LEFT RIGHT

B-d medial length from prominent point of malleolus to knee crease

B-e lateral length from prominent point

of malleolus to center of patella*

B-g medial length from prominent point of

malleolus to groin, far enough below pubic area so that garment will not

cause discomfort*

B-K lateral length from prominent point of

malleolus to gluteal fold*

FOOT MEASUREMENTS

LANDMARK MEASURING POINTS

juXTA-FiT™ & juXTA-LiTe™ sTAndArd AnkLe FOOT wrAP

(AFw) sizes

leFT righT S M L

B ankle circumference around malleoli < 36cm < 36cm < 41cm

h arch circumference 19-24cm 24-29cm 29-34cm

a-y length from base of great toe to where foot meets ankle > 9cm > 9cm > 9cm

z length from base of toes to back of heel (For Interlocking AFW) 13-25cm 13-25cm 13-25cm

z length for Standard Juxta-Fit™ & Juxta-Lite™ AFW§ > 16cm > 16cm > 16cm

B-z length from floor to center of medial malleoli

a circumference at base of toes

y circumference around heel to where foot meets ankle

P2 length from malleoli to malleoli, pass under heel

graduaTe™ COlOr OPTiOns

Exterior Foam Liner r BLACk r BEIGE r RED r TURQUOISE

Interior Foam Liner N/A r BEIGE r RED r TURQUOISE

CA-CSL-050212-02

MEASUREMENT STARTS FROM MALLEOLUS, NOT FROM FLOORNote: Measurements B-D & B-G are where garment will typically begin and end. If Shelves, Folds, or trouble Areas are Present, Please Draw Shape of Patient’s Leg Darker on Sample or on Separate Sheet. *Required for ALL except Lower Legging

1. This chart must be submitted with a completed Custom Garment Order Form on page 10.

2. Record all measurements in centimeters. Take circumference measurements starting at the malleolus and every 5cm above. For Lower Leggings end circumference measurements at knee crease. All other garments continue taking circumference measurements up the leg, including the patella, to the groin (required for proper knee-and-above positioning and placement).

3. Complete length and foot measurements. Provide contour and linear lengths when measuring an uncommon limb shape.

4. Take measurements in shaded areas for standard sized leggings and ankle-foot wraps. NOTE: 1in = 2.54cm

‡ EZ Single-Band Standard Ankle-Foot Wrap™ included by default§ Comfort Compression Anklets™ included by default§ Juxta-Lite™ AFW not available in large

B-G*

B-DB-E*

B-K* E*

B-ZA

B

H

Z

A-Y

Y

3P2

S I Z I N G C H A r TC U S T o m L e G G I N G

JuxTa-FiT™ sTandard legging sizes

11

ARM CIRCUMFERENCEMEASUREMENTS

(Palm; wrist; 5cm increments from the wrist to the axilla)

MEASURING POINTS

Palm

Wrist

5cm

10cm

15cm

20cm

25cm

30cm

35cm

40cm

45cm

50cm

55cm

ARM LENGTH

c-e c-g

wrist to elbow crease

wrist to axilla (or where the garment

should end)

ARM AND HAND SELECTION

r RIGHT r LEFT

DATE PATIENT NAME FACILITY NAME CONTACT REORDER

r yes r No

ARMSLEEVE PRODUCT r Juxta-Fit™ Armsleeve r Measure-Up™ Armsleeve

This chart must be submitted with a completed Custom Garment Order Form from page 10. Measure patient’s arm length with the arm straight. Also, ensure that the arm is at its smallest and maintains arm size from the time of measuring to assure a proper fit of the garment(s). 1in = 2.54cm

Note: Juxta-Fit™ Armsleeve length (measured medially) is determined from wrist-to-axilla length provided. A lateral rise is incorporated at the top of the garment in addition to a 10° bend at the elbow. Each Juxta-Fit™ Armsleeve comes with a Comfort CoverUp™ (a beige coverup will be sent if a color is not selected.)

Note: Measure-Up™ Armsleeve length (measured medially) is determined from wrist-to-axilla length provided. If this length is equal to the borderline, the armsleeve is built to the longer length unless specifically requested to be built to the shorter length (see measurement chart below). Each Measure-Up™ Armsleeve comes with a hand cover and a Comfort CoverUp™ (a black CoverUp will be sent if a color is not selected.)

JuxTa-FiT™ GLOVE MEASUREMENTS

lengTh1 2 3 4 5 6 7 8 9 10

CirCumFerenCe

1x 2x 3x 4x 5x a b c

1w 2w 3w 4w 5w

measure-uP™ OPTIONSgarmenT

lengTh r 37cm (6 bands) r 43cm (7 bands) r 49cm (8 bands) r 56cm (9 bands)

c-g Measurement Ranges 33cm -39.4cm 39.4cm-45.8cm 45.8cm -52.1cm 52.1cm -58.5cm

exTeriOr FOam liner r BLACK r BEIGE r RED r TURQUOISE

inTeriOr FOam liner N/A r BEIGE r RED r TURQUOISE

JuxTa-FiT™ GAUNTLET SIZE OPTIONS

Palm CirCumFerenCe 14-17cm 17-20cm 20-23cm 23-26cm 26-29cm

size r XSMALL r SMALL r MEDIUM r LARGE r XL

COmFOrT anCillaries™ UNDERSLEEVE OPTIONSr COMFORT ARM LINER™ (wITH THUMBHOLE) max limb circumference: 54cm

r COMFORT SILVER ARM LINER™ (wITH THUMBHOLE) max limb circ: 54cm

r COMFORT ARM STOCKINETTE™ (SINGLE PLY) max limb circumference: 56cm

JuxTa-FiT™ HAND OPTIONS

r GAUNTLET

r GLOVE

r DORSUM STRAP

r NONE

COmFOrT COveruP™ r BLACK

r BEIGE

r PINK

CA-CSA-020712-01

MEASUREMENTS 1x-5x: the circumference of each finger at the Proximal Interphalangeal joint (PIP) or if the base of the finger is larger than the PIP please use the larger measurement.

MEASUREMENT b:circumference of palm at base of thumb webbing

MEASUREMENT a:circumference of palm at base of pinky finger

MEASUREMENTS 1w-5w: the circumference where the glove should end; commonly, the Distal Interphalangeal joint (DIP).

MEASUREMENT c: circumference of the wrist

MEASUREMENTS 1-5: length of finger from the center of the crease at base to where the glove should end

MEASUREMENT 8: length from the crease between the ring finger and pinky finger to the base of the palm

MEASUREMENT 10: width of palm at base of pinky finger

MEASUREMENT 9: width of palm at base of thumb webbing

MEASUREMENT 6: length from base of index finger to the base of thumb webbing

MEASUREMENT 7: length from base of index finger (same as 6) to base of palm

1w

2x3x

4x

5x

b

a

2w

3w

4w

5w

1x

c

c-e

c-g

16

2

3

4

5

8

9

10

7

S I Z I N G C H A r TC U S T o m A r m S L e e V e

12

sTandard size COmPressiOn sysTems:• JUXTA-FIT™ PREMIUM STANDARD LEGGINGS: one compression legging, one pair of Comfort Silver Leg Liners™, and one

pair of Comfort Compression Anklets™. (Comfort EZ Single-Band Ankle-Foot Wrap™ available upon request.)

• JUXTA-FIT™ ESSENTIALS STANDARD LEGGINGS: one compression legging, one pair of Comfort Leg Liners™, and one pair of Comfort Compression Anklets™. (Comfort EZ Single-Band Ankle-Foot Wrap™ available upon request.)

• JUXTA-LITE™ STANDARD LEGGINGS: one compression legging, one Comfort Leg Liner™, BPS™ card and a pair of Comfort Compression Anklets™.

• INTERLOCKING STANDARD LEGGINGS (READY-FIT™ AND CLASSIC-FLEX™): one compression legging, one pair of Comfort knee-High Socks™, a Comfort EZ Single-Band Ankle-Foot Wrap™ and an instructional DVD.

• JUXTA-CURES™ LEGGINGS: one compression legging, six Velcro® stays, one pair of Comfort Leg Liners™, one pair of Comfort Compression Anklets™, one BPS™ card, and one disposable paper measuring tape. Five (5) and four (4) packs of Juxta-CURES™ Leggings include one clinician instructional DVD and one patient instructional DVD.

• CIRCPLUS™ VEIN PROCEDURE COMPRESSION SYSTEM: one Comfort Capri™ and one pair of 30-40 mmHg below-knee elastic compression stockings.

• Instructional DVDs are available upon request, unless otherwise noted.

CusTOm COmPressiOn sysTems:• CUSTOM JUXTA-FIT™ ARMSLEEVE: one compression armsleeve, elbow band, and one Comfort CoverUp™ and an

instructional DVD.

• CUSTOM JUXTA-FIT™ wHOLE LEG: one compression legging, one Comfort Non-Slip Liner™, one pair of Comfort Silver Thigh-High Socks™ and Comfort Silver knee-High Socks™, custom knee-cover, one Comfort CoverUp™ , shelf straps (as needed), and a choice of a Juxta-Fit™ Ankle-Foot Wrap or Juxta-Fit™ Interlocking Ankle-Foot Wrap.

• CUSTOM JUXTA-FIT™ UPPER LEG AND UPPER LEG wITH KNEE LEGGINGS: one compression legging, one Comfort CoverUp™, one Comfort Non-Slip Liner™, one pair of Comfort Silver Thigh-High Socks™ and Comfort Silver knee-High Socks™, and shelf straps (as needed).

• CUSTOM JUXTA-FIT™ LOwER LEG: one compression legging, one pair of Comfort Silver knee-High Socks™, shelf straps (as needed) either one pair of Comfort Compression Anklets™ or one Comfort EZ Single-Band Ankle-Foot Wrap™.

• CUSTOM JUXTA-FIT™ KNEE PIECE: one compression garment, one pair of Comfort Silver Thigh-High Socks™ and one custom knee-cover.

• CUSTOM JUXTA-FIT™ LOwER LEG wITH KNEE LEGGINGS: one compression legging, one pair of Comfort Silver Thigh-High Socks™, shelf straps (as needed) either one pair of Comfort Compression Anklets™ or one Comfort EZ Single-Band Ankle-Foot Wrap™.

• CUSTOM CLASSIC-FLEX™ LEGGINGS: one compression legging, one pair of Comfort Silver knee-High Socks™ and one Comfort EZ Single-Band Ankle-Foot Wrap™, foam inserts, an instructional DVD and shelf straps as needed.

• CUSTOM GRADUATE™ wHOLE LEG: one compression legging, one pair of Comfort Thigh-High Socks™, one Comfort CoverUp™, a pair of gradient measuring cards and an instructional DVD.

• CUSTOM GRADUATE™ BELOw KNEE LEGGING: one compression legging, one pair of Comfort knee-High Socks™, a pair of gradient measuring cards and an instructional DVD.

• CUSTOM MEASURE-UP™ ARMSLEEVE: one compression armsleeve, two Gradient Measuring Cards, one Comfort Arm Liner™, one Comfort CoverUp™, one hand cover and an instructional DVD.

• Instructional DVDs are available upon request, unless otherwise noted.

OTher garmenTs, FOOT PieCes and anCillary PrOduCTs:• Unless otherwise indicated these products are packaged individually.

PACKAGe CoNTeNTS13

shiPmenTs Orders will be shipped via UPS, or appropriate, charges prepaid, unless otherwise specified by customer. All U.S. custom garments carry a guaranteed five day delivery. All domestic standard garment orders totaling $500 or more (pre-discount) will receive free standard shipping.

quanTiTy disCOunTs COMFORT NON-SLIP LINER™: Orders for Comfort Non-Slip Liners™ of four or more will receive a 50% discount off the retail price.

COMFORT SOCk LINERS: Order ten pairs of any Comfort Sock Liner™ (Comfort, Cotton Terry, Silver, Stockinette, Anklet) and receive two pairs free.

reTurns and exChanges All returns must receive advanced authorization from CircAid® Medical Products, Inc. CircAid® will not accept product for return or exchange 30 days after the sale to the customer. A 15% re-stocking fee on all returns that are in salable condition is charged to the customer. Please request a return authorization number from a CircAid® Customer Service Representative prior to returning product. Once product has been used product may not be returned or exchanged, excluding returns for manufacturing defects. If determined to be defective, CircAid® will at its discretion repair or replace the merchandise. Return authorizations may take up to five business days to process. Credits to accounts must be used within one year of issue date and will be applied to outstanding balances only. Custom-made, special order products, Comfort Non-Slip Liner™ and Comfort Capri™ cannot be returned or exchanged.

WarranTy1. Juxta-Fit™ Premium Legging Systems: Product is warranted to be free of defects in materials and workmanship. The product will perform

according to and under the stated application and use procedures (including alterations as directed) for a period of one year from the date the garment is shipped or from the date of purchase for a standard size product. The warranty is only valid if the instructions for care are followed properly and does not cover normal wear and tear, abnormal care and use, or where it can be shown the application instructions have not been followed correctly.

2. Juxta-Fit™ and Juxta-Lite™ Ankle-Foot Wrap: Product is warranted to be free of defects in materials and workmanship. Product will perform according to and under the stated application and use procedures for a period of 90 days from the date the garment is shipped or from the date of purchase for a standard size product. The warranty is only valid if the instructions for use and care are followed properly and does not cover normal wear and tear, abnormal care and use,or where it can be shown the application instructions have not been followed properly.

3. Juxta-Fit™ Essentials Leggings, Armsleeve and Glove: Product is warranted to be free of defects in materials and workmanship. The product will perform according to and under the stated application and use procedures (including alterations as directed) for a period of six months from the date the garment is shipped. The warranty is only valid if the instructions for care are followed properly and does not cover normal wear and tear, abnormal care and use, or where it can be shown the application instructions have not been followed correctly.

4. Graduate™ Whole Leg, Bk Graduate™, and Measure-Up™ ArmSleeve Systems: Product is warranted to be free of defects in materials and workmanship. Product will perform according to and under the stated application and use procedures (including alterations as directed) for a period of one year from the date the garment is shipped. Products found to be defective after the first six months can be returned for repair only. The warranty is only valid if the instructions for care are followed properly (hand wash and air dry only) and does not cover normal wear and tear, abnormal care and use, or where it can be shown the application instructions have not been followed correctly.

5. Juxta-Lite™ Product will perform according to and under the stated application and use procedures and is warranted to be free of defects in materials and workmanship. The warranty is only valid if the instructions for care are properly followed; and does not cover normal wear and tear, abnormal care and use, or where it can be shown the application instructions have not been followed correctly. The warranties are:

• Juxta-Lite™ Standard Legging: Six months from the date of purchase.

• Juxta-Lite™ Ankle-Foot Wrap: 90 days from the date of purchase.

• Comfort Compression Anklet™: Product will be replaced only if there is any manufacturing defect.

6. Ancillary Products (EZ Single-Band Ankle-Foot Wrap, Gauntlet, Undersocks, Stockinette, Shelf-Strap, knee Cover, etc.): Product will be replaced only if there is any manufacturing defect.

Terms F.O.B., San Diego, CA. Net 30 for approved accounts, all others C.O.D or credit card. Visa, MasterCard, and American Express accepted. Please request an Account Setup form or Credit Application from Customer Service for establishing an account. Orders shipped outside of the USA are payable in advance in U.S. dollars by draft on a U.S. bank.

PRICES SUBJECT TO CHANGE WITHOUT NOTICE. MSRP prices may vary due to geographic location, local fitting services, shipping expenses, etc.

Physician Prescription required for all custom products.

CircAid Medical Products, Inc., assumes no liability for injury or damages resulting from contraindicated use of its products. CircAid is a Registered Trademark and Juxta-CURES, Compression Ulcer Recovery System, Juxta-Fit, Juxta-Lite, Graduate, Measure-Up, Classic-Flex, Ready-Fit, Comfort Capri, Comfort Non-Slip Liner, Comfort CoverUp, Comfort Cotton Terry knee-High Sock, Comfort Cotton Terry Thigh-High Sock, Comfort Arm Liner, Comfort Leg Liner, Comfort knee-High Sock, Comfort Thigh-High Sock, Comfort Silver Arm Liner, Comfort Silver knee-High Sock, Comfort Silver Thigh-High Sock, Comfort Arm Stockinette, Comfort Thigh-High Stockinette and Comfort knee-High Stockinette are trademarks of CircAid Medical Products, Inc. Breath-O-Prene is a registered trademark and SILVERtec is a trademark of AccuMED Technologies, LLC. Lycra is a registered trademark of INVISTA. Velcro is a registered trademark of Velcro USA, Inc. ©2012 CircAid Medical Products, Inc. All rights reserved.

TermS ANd CoNdITIoNS14

9323 Chesapeake Drive, Suite B2 · San Diego, CA 92123© 2012 CircAid Medical Products, Inc. All rights reserved.

CA-FB-052512-01

need mOre Order FOrms Or sizing CharTs? Call us at: Email us at: Fax us at:

2012 order forms & sizing guides - brightlife direct · pdf filecustom juxta-fit™...

Documents