Bioflex Form
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Instructions

Complete all the requested information in the measurement form below. Measure both the left and the right leg. Patient should be in the supine position. Light tension in the tape-measure is desirable. Measurements L5, L6, L8, and L10 are not required for the standard above-the-knee version of the Bioflex Electrode Garment for the ERGYS or REGYS.

PLEASE INCLUDE A SIGNED PHYSICIAN'S PRESCRIPTION SHEET WITH THIS FORM.                         
Send completed forms to:  Therapeutic Alliances Inc.
                          333 N. Broad Street
                          Fairborn, Ohio  45324
                          (937) 879-0734
              Or fax to:  (937) 879-5211 
               

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Bioflex is a trademark of Bioflex Inc.

 

Therapeutic Alliances Inc.
333 North Broad Street - Fairborn, OH 45324  USA
(937) 879-0734 - (937) 879-5211 (fax)   www.MusclePower.com

This page and all Therapeutic Alliances-designed link pages are Copyright 1996-2012 Therapeutic Alliances Incorporated, Fairborn, Ohio USA. All rights reserved. Therapeutic Alliances Inc., ERGYS®, REGYS, SpectraSTIM®, NeuroEDUCATOR®, Stimwear®, "You Are the Moving Part," and "The Power of Your Muscles" are trademarks of Therapeutic Alliances Inc. Control Bionics and NeuroSwitch are trademarks of Control Bionics Inc. Parastep is a trademark of Sigmedics Inc.

Send mail to info@ERGYS.com with questions or comments about this web site.