Juzo custom order form 2025

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  1. Click ‘Get Form’ to open the juzo custom order form in the editor.
  2. Begin by filling out the Account Information section. Enter your Account Number, Date, Account Name, and Contact details clearly.
  3. In the Order Information section, specify the Quantity of items you wish to order and select the Extremity (Right or Left).
  4. Choose your desired Compression level from the options provided (e.g., 18-21 mmHg, 23-32 mmHg).
  5. Fill in Circumference Measurements and Lengths accurately for a customized fit. Ensure all measurements are taken on the medial side of the leg.
  6. Indicate any Special Requests such as Open Toe or Closed Toe options, and provide additional details if necessary.

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Versions Form popularity Fillable & printable
2019 4.3 Satisfied (30 Votes)
2016 4 Satisfied (22 Votes)
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