Lastofa Forte MASTER TEMPLATE

Juzo Expert Colour:: (Required) Sugar Sesame Almond Cinnamon Cocoa Poppy Seed Blueberry Black Pepper Trend / Fashion Colour

Juzo Expert Colour Option:: Optional None Batik White Batik Black Dip Dye Blueberry Dip Dye Poppy Seed

RAL Class:: (Required) Class 1: 18-21 mmHg Class 2: 23-32 mmHg Class 3: 34-46 mmHg Class 4: >49 mmHg

Customisation Option:: Optional None Overheight Max Overheight at the Front of the Leg

Border:: (Required) No Border Silicone Border 3.5cm Silicone Border 5cm Balance border 3.5cm Balance border 5cm Lace Border 5 cm Elastic Border 3.5cm Silicone Free

Additional Options:: Optional None Silicone Stopper Outer Side Silicone Stopper Front Hip Attachment Left Hip Attachment Right Hip Attachment - worn as a pair

Left Foot Style:: (Required) Open Toe Closed Toe Ball Stub / Diagonal Foot

Additional Foot Options:: Optional None Additional Instep Stitching Tricot Lining at cY Pressure Pads by Dr Rotter Malleoli Pads Glued In Pads Loose Pads With insert Pocket

Zip Option - Left:: Optional None Zip Option - Left

Measured by:: (Required) Marianne Nicola Therapist Self / Family Other

Patient Name/Ref:: (Required)

Juzo Expert AD Knee High Left Leg

Juzo Expert

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