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Measuring for Compression
Measurement Form
Patient Name
*
First Name
Last Name
Right Ankle
Left Ankle
Right Calf
Left Calf
Right Leg Length To Knee
Left Leg Length To Knee
Right Thigh
Left Thigh
Hips
Waist
Right Full Leg Length
Left Full Leg Length
Sock Selections
(Brand/Style/Colour/Length/Quantity)
Select Next Steps
*
I am ready, please process my order!
Please save my sock "wish list" above until I send my prescription to linda@klhealth.com
*
I confirm that the information I have provided is accurate and clear. Any changes after this point may result in processing delays and additional costs.
Thank you!