Custom Fabrication Order Forms
AK by Measurement Order Form
Order a transfemoral socket online using this form. Once submitted, the order goes directly to our custom fabrication team. Please be sure to complete all information on the form. View available brim shapes.
BK Check Socket Order Form
Print and complete the order form for a transtibial check socket. Then include the form with the plaster cast. If sending a shape file from OMEGA® Tracer® please fax the form to 888.878.4858 . Please be sure to complete all information on the form.
Alpha DESIGN® AK Liner Order Form
Complete the order form and press the "Print" button at the bottom. Include one copy with the cast of the residual limb only. Missing information may delay your order. Please fill out the form accurately. For bilateral amputees, please complete separate forms for each residual limb.
Alpha DESIGN® BK Liner Order Form
Complete the order form and press the "Print" button at the bottom. Include one copy with the cast of the residual limb only. Missing information may delay your order. Please fill out the form accurately. For bilateral amputees, please complete separate forms for each residual limb.