Knee Brace Fitting and Adjustment Form
Please provide the following information to help us fit and adjust your knee brace for optimal comfort and support.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Which knee or leg will the brace be used on?
*
Left Knee
Right Knee
Both Knees
Reason for Knee Brace
*
Please Select
Post-surgery support
Ligament injury (ACL, MCL, etc.)
Arthritis or joint pain
Sports injury prevention
General instability
Other
Type of Knee Brace
*
Please Select
Hinged brace
Sleeve brace
Wraparound brace
Custom-molded brace
Patella stabilizing brace
Other
Please describe any current fit issues or discomfort with your knee brace.
Measurement Details for Fitting (please provide in centimeters or inches)
*
Rows
Measurement
Thigh circumference (10 cm above knee)
Knee circumference (at center of kneecap)
Calf circumference (10 cm below knee)
How many hours per day do you typically wear your knee brace?
*
Please Select
Less than 1 hour
1-3 hours
4-6 hours
7-12 hours
All day (12+ hours)
Please rate your current comfort or pain level while wearing the brace.
*
No discomfort
1
2
3
4
5
6
7
8
9
Severe discomfort
10
1 is No discomfort, 10 is Severe discomfort
Have you used a knee brace before?
*
Yes, regularly
Yes, occasionally
No, this is my first time
Additional fitting notes or instructions for the specialist
Submit
Should be Empty: