All Forms·Corona · InlandDME@gmail.com
Inland DME

Orthopedic Order

1426 W. 6th St Suite 108 Corona, CA 92882 · (951) 278-1222

Patient Information

Check all that apply

KNEE

KNEE: Hinged Brace w/ Adjustable Joints, Prefab
KNEE: Hinged Brace w/ Adjustable Joints, Custom
KNEE: Soft Interface, below knee, 2 per leg
KNEE: Soft Interface, above knee, 2 per leg
KNEE: Non-corrosive Finish, 2 per leg
KNEE: Condylar Pad, 2 per leg
KNEE: Suspension Sleeve, 2 per leg

BACK

BACK: Lumbar-Sacral Brace, sagittal-coronal control, w/ rigid anterior + posterior panels, straps and closures

ANKLE

ANKLE: Ankle Control Brace
ANKLE: AFO Brace

WRIST

WRIST: Wrist Brace, without joints

FOOT

FOOT: CAM Walking Boot, pneumatic
FOOT: Foot Drop Splint
FOOT: Diabetic Shoes, 1 for each foot
FOOT: Diabetic Inserts, foam, 3 for each shoe

ELBOW

ELBOW: Elbow Brace w/ locking joints

SHOULDER & NECK

SHOULDER & NECK: Shoulder Brace, acromio/clavicular
SHOULDER & NECK: Cervical Collar, semi-rigid, thoracic

HERNIA

HERNIA: Truss, double w/ standard pad

Prescriber Information

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