Form online 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section 1, where you will input the Shaf Length. Enter the desired length in mm, ensuring it falls between 5 mm and 60 mm.
3. Proceed to Section 2, which requires you to select the Shaf I.D. and O.D. from the provided options. Choose the appropriate sizes that meet your specifications.
4. In Section 3, check one box for the Connector type. Ensure you select either Swivel or Fixed based on your needs.
5. Continue to Section 4 and select a Neck Flange option by checking one box only. Fill in any required lengths as specified.
6. For Section 5, choose a Cuf option by checking one box only that fits your requirements.
7. Complete Sections 6 and 7 by selecting any additional options needed for your order, including Cuf positions and attachments.
8. Finally, fill out the Approval section with details such as Hospital/Clinic name, Clinician Name, Title, P.O. Number, and Date before submitting your form.

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