Upper Extremity Measurement Form Phone: 317-892-8180Fax: 317-534-3440sorgisports@sorgisports.comVisual Text STEP 1: Select Product Line *JAS (Rental)JAS EZ (Purchase)JAS Dynamic (Renatl)STEP 2: Select Direction *ExtensionFlexionSupinationPronationSTEP 3: Select Side *LeftRightSTEP 4: Personal Information Height (In) *Weight (lbs) *STEP 5: Choose Orthosis *ElbowPro/SupWristFinger STEP 6: Take Measurements (Refer to Measurement Guide) If Elbow was selected - A, B, C, E, F, G, H(See Note 1)If Pro/Sup was selected - A, B, C, E, F, H, I, J (See Note 2)If Wrist was selected - B, C, GIf Finger was selected - D, J, KVisual Text STEP 7: Record Measurements (in Inches) Below A Circumference: Largest point of BicepB Circumference: Largest point of ForearmC Circumference: 1 1/2" proximal to Ulnar StyloidD Circumference: Affected Finger proximal PhalanxE Length: Axilla to Medial EpicondyleF Length: Axilla to Crease of ElbowG Length: Crease of Elbow to Ulnar StyloidH Length: Lateral Epicondyle to Ulnar StyloidI Length: Ulnar Styloid to 5th MP JointsJ Length: Width of Hand across MP JointsK Length: Affected Finger MP Joint to tip of FingerHTML Visual Text Contact Info Name *Email *Phone * VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
