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Crutch Order Form (Print this page to fax or mail your order)
Getting the correct measurements to order
custom made crutches is easier than you might think. Check Here for measuring directions. Your most important
assignment is to carefully read and understand these instructions and fill in
all the information requested. Let's start with the simple stuff.
Name.........................................................................................
Street Address............................................................................................................................
Important Note: We ship via UPS so we must have a street address.
Apartment #.................
City..................................................................
State....................................... Zip Code....................
Country....................... Daytime Phone (......)........................
Credit Card #................................................................Expires....................
Now for the personal part...this info I use to equate with your crutch
measurements. I will call you if I sense something is not right.
Your Height.......... Weight.............. Age............
Activity level: Check one of the following that fits you best.
......... Gorilla: You are big, strong and athletic. You regularly go hunting, fishing, hiking, climbing, go up two stairs
at a time, etc. and it seems like you break your crutches all the time. (For you
we highly recommend our Super Duty Collar & Post for an up-charge of $50.00
pair.
......... Draft Horse: You regularly go out everyday to work or for walks,
go food shopping, do house chores, go to movies and travel.
......... Pussy Cat: While you may have once been a adept and agile hunter in the wild, you now spend
most of your time lounging around your home sitting in the sun reading a good
book.
FOREARM CRUTCH MEASURING
Crutch Style:
Regular.............. Lo-Bend .............
Basically you should stay with the style crutch you are used to. The regular style is by far
the most common. It has a 17° bend above the handgrip. The Lo-Bend style has a 21°bend below
the handgrip and is useful to those people who lean far forward when walking.
Lo-Bends will bring the crutch tips closer to their feet making them walk taller
without compromising their balance. If in doubt, try our Demo Program.
Crutch Measurements: X=........... Y=......... Distance around largest part of your forearm ..........
Choice of Handgrips: Performance Gel Grips........... Right Grips .......... Endurance Grips ............
Choice of Crutch Tips: Tornado Tips .......... Performance Tips ..........
Color Choice:
Litestix Titanium: Natural Luster........ Black Powder Coat........
Litestix Aluminum Black Powder coat only
Superlite Adjustable Crutches:Silver, Jet-Black.
Sorry, custome hand designed colors are not available on adjustable crutches.
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