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OSSUR AK Check Socket Order Form v2

OSSUR AK Check Socket Order Form v2 2026

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The document is an order form for above-knee check sockets from Össur, detailing billing and shipping information, patient details, measurements, construction specifications, and component selections necessary for creating a custom prosthetic socket. It emphasizes the importance of accurate information to ensure high-quality product delivery.

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Click ‘Get Form’ to open the OSSUR AK Check Socket Order Form v2 in the editor.
Begin by filling out the 'Billing & Shipping Information' section. Enter your Össur Account # if you have one, or complete the fields below with your company name, address, city/state/zip, contact person, phone number, and email.
Specify the 'Date Needed in Office' and include a PO# if applicable. Choose your shipping priority from options like Next Day Air or 2nd Day Flat Rate.
In the 'Patient Information' section, provide the patient's name/reference, amputation level (AK), and activity level. Fill in any required measurements accurately.
Complete the 'Construction' section by selecting materials for both outer and inner socket components. Indicate any suspension options that apply.
Finally, review all entries for accuracy before saving or sending your completed form directly through our platform.

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What is a prosthetic socket?

Consequences of ill-fit Ill-fitting sockets compound issues of residual limb health, facilitating skin breakdown and pressure sore development. An ill-fitting socket can put excess pressure on load-intolerant anatomy, which can cause enough pain and discomfort to stop prosthesis use.

What are prosthetic sockets made of?

Below the Knee Prosthetic Leg Cost BrandStarting PriceKey Features Ottobock $4,000 Type of carbon foot, silicone liner ssur $3,750 Active vacuum system, carbon foot options Jan 11, 2024

How long does a prosthetic socket last?

Debunking the Myth of Lifetime Prosthetics Prosthetic components are typically designed to last 2-4 years, but sockets often need replacement sooner due to changes in the residual limb.