• Transtibial Check Socket Order Form v 5.4

    Transtibial Check Socket Order Form v 5.4

    Standard Fabrication 1-3 Business Days

  • We have a new form that has been created to improve your ordering experience.

     

    Please click on the link below.

     

    https://hangerfabrication.com/prosthetic

     

     

    ( We also ask that you bookmark the HFN Fabrication form site link.)

    • Account Information 
    • Order Information 
    • Today's Date
       - -
    • Requested Due Date*
       - -
    • May we proceedwith fabrication or is the Job on HOLD?
    • Design 
    • Socket Design*
    • Browse Files
      Cancelof
    • If a Discrepancy Exists, Go By*
    • Units of Measure*
    • Image field 37
    • Rows
    • Socket 
    • Plastic Type*

    • Vacuum Forming Method*
    • Insert 
    • Custom Insert Material

    • Insert Thickness*

    • Add Ons

    • End Pad Material

    • End Pad Thickness*

    • Removable End Pad*
    • Suspension 
    • Shuttle Lock

    • TSB

    • Elevated Vacuum

    • PTB

    • Components 
    • Support Structure
    • Component
    • Component Material
    • Pylon Diameter
    • Socket Attachment

    • Attachment Shape
    • Attachment Rotation
    • Finishing 
    • Guidelines
    • Trimlines
    • Posterior Shelf Shape
    • Setup/Alignment 
    • Set Up

    • Socket Flexion Angle

    • Socket Coronal Angle

    • Rotation of Leg
    • AOPS Billing 
    • Should be Empty: