Custom Order Forms

Not everyone is able to use off-the-shelf compression garments. If all your measurements don't fit in the size chart for a single garment, you may need a custom garment. Fortunately, there are several available.

Below are order forms your therapist or doctor can use to order custom compression garments through Medical Stockings Online. You will NEED proof of medical need, measurements taken by a trained professional, and the professional's signature so don't bother submitting the order yourself. But you can print the form for your therapist and take it to your appointment if you like.

Custom orders are individually priced based upon measurements and options. Call us or fax the completed form for a price quote.

Juzo Custom Garment Order Forms

• Hand
• Flat Knit (Strong or Strong Silver) or Circular Knit (Varin, Soft, Varin Silver)
• Knee-Highs
• Thigh-Highs
• Pantyhose
• Toe Glove

These forms are Adobe .pdf for printing accuracy. If you need the free .pdf reader, you can download it at www.adobe.com.