Shiley custom ordering form 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by selecting whether this is a new order or a re-order. Check the appropriate box and specify the quantity of custom tracheostomy tubes you wish to order.
3. Fill in the accessories included with each tube, and if applicable, provide any special instructions. If this is a re-order, list the previous lot number.
4. Select the size of the cannula from the provided options and specify the standard length required. Ensure all dimensions are noted in millimeters.
5. Indicate your desired cannula length, either standard or modified, and provide measurements for both proximal and distal lengths as needed.
6. Complete your contact information including shipping address, phone number, and fax number. Make sure to include any specific shipping instructions.
7. Choose your cuff type and specify any rotation or curve requirements for the cannula. Fill in physician and patient names as necessary.
8. Finally, indicate fenestration preferences if applicable, providing details on location and size modifications.

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