Facial and Neck Pad

FACIAL/NECK PAD
P: 866.931.0876
F: 866.931.0052
Measure & Order Form
[email protected]
PO#:
Date:
Company:
Phone:
Contact Name:
Patient:
Sex:
Age:
Ht:
Wt:
Bill-To Name & Address:
Ship-To Name & Address:
PRODUCT INFORMATION
SIZE:
PAD:
SMALL
LARGE
MEDIUM
Item # 2950: Neck/Cranial
Item #2940: Neck/Mandible
ACCESSORIES (additional cost):
Velcro extender (5cm additional circumferencial range) Qty.
SIZING CHART
Head Circumference
Neck Circumference
X - LARGE
SMALL
53 - 56
MEDIUM
56 - 58
LARGE
58 - 61
X - LARGE
61 - 64
28 - 33
33 - 38
38 - 43
43 - 58
Head Circumference
(measure 1/2” above eye brow)
Neck Circumference
(measure at largest part of neck)
BiaCare.com
•
P: 866.931.0876
•
F: 866.931.0052
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