Underarm Crutch Order Form

(Print this page to mail with your order and tracing)

Getting the correct measurements to order custom made crutches is easier than you might think. Your most important assignment is to carefully read and understand the 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.

           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 an 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.

A full size tracing for all Underarm crutch orders is required.

UNDERARM CRUTCH MEASURING


Titanium Shepherds Crutch        Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .             

Natural Luster              Powder Coat Black          .


Titanium Unipoise Crutch        Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .             

Natural Luster              Powder Coat Black          .


Titanium Underarm Crutches        Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .             

Natural Luster              Powder Coat Black          .


Aluminum Shepherds Crutch        Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .             

Powder Coat Grey               Powder Coat Black          .


Aluminum Unipoise Crutch        Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .             

Powder Coat Grey               Powder Coat Black          .


Aluminum Underarm Crutches        Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .             

Powder Coat Grey               Powder Coat Black          .


A full size tracing for all Underarm crutch orders is required.


Wooden Underarm Crutches

Measurement X            Measurement Y            .

Performance Tips               Tornado Tips          .

Rubber Underarm Pads              Slim Line Underarm Pads          .    

 

Choice of Wood        

Rock Maple          $795.00     

Oak                     $795.00      

Rosewood            $895.00

 

Wooden Top: 8”          .

Sling Top: 8"               9"               10"          .


Kenny Armband Crutch



Measurement X                 Measurement Y                 Measurement Z            .

Performance Tips               Tornado Tips          .

 

Choice of Wood        

Rock Maple          $795.00     

Oak                     $795.00      

Rosewood            $895.00

 

 

A full size tracing of your crutch is required, in addition to front and side views of the arm cuffs, for us to insure the accuracy of your

Kenny Armband crutch.