REF Magic Therapist / DME
Provider Information Saved on this device
Choose how your office sends orders. You can change this later.
Therapist / fitter contact information
Used on custom manufacturer forms. Billing and shipping fields remain blank when ordering through a DME.
One-time account information
No patient names or payment card details are saved. Order date is filled automatically; PO number and shipping service stay blank for each order.
Select products
Head & Neck
Products will be added after sizing and REF verification.
Arm
Products will be added after sizing and REF verification.
Above Knee
Products will be added after sizing and REF verification.
Below Knee
Treated legs
2. Enter measurements
Testing only — replaces entered measurements with fictional sample values. Do not use for patient orders.
3. Generate REF
Forms Library
Blank copies for printing or downloading. These are reference templates, not completed patient orders.
Head & Neck / Bra
Head & Neck / Bra Measurement Form
Printable worksheet for Tribute Wrap Head & Neck and Tribute Wrap Bra.
Download / PrintArm
Arm Measurement Form
Printable worksheet for ReadyWrap Arm and Gauntlet, Tribute Wrap Glove, Wrist to Axilla, and MCP to Axilla.
Download / PrintAbove Knee
Above Knee Measurement Form
Printable worksheet for ReadyWrap Knee and Thigh, ExoStrong Thigh High, and Tribute Wrap Knee to Thigh and Full Leg. Full Leg also requires the Below Knee form.
Download / PrintBelow Knee
Below Knee Measurement Form
Printable clinician measurement worksheet for ReadyWrap Calf / Fusion Kit, Tribute Wrap Below Knee, ReadyWrap Foot / CT / SL, ExoStrong Below Knee, and toe caps.
Download / PrintReadyWrap Lower Extremity Order Form
Official L&R blank form — includes Calf and Foot CT.
Download / PrintTribute Wrap Lower Extremity Order Form
Official L&R blank form — includes Below Knee.
Download / PrintReadyWrap Custom Lower Extremity Order Form
Blank current ReadyWrap custom order form for printing and manual completion. Confirm measurements and design details with the Design Center.
Download / PrintCustom Tribute Wrap Below Knee Order Form
Blank TributeNight Leg & Lower Torso form currently used for custom Tribute Wrap Below Knee orders. Complete measurements and confirm design selections with the Design Center.
Download / Print