JOBST® JoViPads Head, Neck and EyeFAX ORDER TO CUSTOMER SERVICES ON:
0845 122 3450
Product Size
Chin Strap Standard S76133-00
M76133-01
L76133-02
XL76133-03
Chin Strap Extended S76134-00
M76134-01
L76134-02
XL76134-03
Facial and Neck GarmentSize Head circumference Neck circumference
S 53 - 56cm 28 - 33cm
M 57 - 58cm 34 - 38cm
L 59 - 61cm 39 - 43cm
XL 62 - 66cm 44 - 48.5cm
To be completed by the treating doctor / nurse specialist
Product Size
Neck Pad UniversalCovers neck and back ear
S / M77610-00
L / XL77610-01
Neck Pad Peri-AuricularCovers the neck front and back ear
S / M76407-00
L / XL77610-02
Eye PadWith band
S76135-00
L76135-01Measurements
EyepadSize Head circumference
S/M 53 - 58.5cm
L/XL 58.5 - 66cm
Head circumference1.5cm above eyebrow
Neck circumference Widest part
2109
/517
an SCA company
Head and Neck Strap RemarksHead and Neck Pads
Type:
Standard Extended
Size:
Quantity:
BSN Code:
Type:
Universal Peri-Auricular Eye
Size: S / M L / XL
Quantity:
BSN Code:
Customer Service: 0845 122 3600 Compression Therapy Helpline: 0800 389 8424 Email: [email protected] www.bsnmedical.co.uk
Steps: 1. Complete order box for JOBST JoViPads. 2. Select garment style required. 3. Complete ALL applicable measurement boxes. 4. Fax order
Date: Purchase Order No.: Patient ID: DoB:
Measured By: Tel: Email:
Delivery Address: Invoice Address:
an SCA company
JOBST® JoViPadsGenitalFAX ORDER TO CUSTOMER SERVICES ON:
0845 122 3450
To be completed by the treating doctor / nurse specialistJoViPads Genital pads
Female Male
S 75936-01 75937-00
M 75936-02 75937-01
L 75936-03 75937-02
XL 75936-04 75937-03
Female Genital Pad
Size Hip circumference
S 86 - 99cm
M 100 - 110cm
L 111 - 120cm
XL 121 - 132cm
Male Genital Pad
SizeSize as measured in
scrotal circumference
S 28 - 35cm
M 36 - 41cm
L 42 - 47cm
XL 48 - 52cm
Size Charts
Order Information Remarks
Female Male
Size S M L XL
BSN Code
Quantity
Female hip circumference measurement
Male scrotal circumference measurement
Customer Service: 0845 122 3600 Compression Therapy Helpline: 0800 389 8424 Email: [email protected] www.bsnmedical.co.uk
Steps: 1. Complete order box for JOBST JoViPads. 2. Select garment style required. 3. Complete ALL applicable measurement boxes. 4. Fax order
Date: Purchase Order No.: Patient ID: DoB:
Measured By: Tel: Email:
Delivery Address: Invoice Address:
