Remote Production of 3D Printed Core (Partial Hand)

Remote Production of 3D Printed Core (Partial Hand)

For Custom Silicone Prosthetic Fabrication
www.functionalrestorations.com

Phone: 919.205.8108

info@functionalrestorations.com
Thank you for entrusting us with your prosthetic production needs. Once you submit this order, we will review your request and reach out to you directly.
Ordering Professional's Name

First Name Last Name
Office or Cell Phone

Area Code Phone Number
Corporate Email Address
example@example.com
Purchase Order Number

Billing Address

Shipping Address (Your Device will be Mailed Here)

Please tell us more about the device you would like us to produce for you.
Involved Side
The following data is required:
- STL or OBJ file of modified residuum and contralateral side (If you are unable to obtain a digital scan, you may mail a plaster positive of the modified residuum and contralateral side)
- Photographs of affected and contralateral side, from all planes
- Measurements (see below)
Email file(s) to info@functionalrestorations.com and reference your PO#.

Please mail any plaster positives to:

(include a copy of your work order with PO# listed)

Functional Restorations, LLC

1821 Hillandale Road

Suite 1B-329

Durham, North Carolina 27705
Measurements - Affected Side
Circumference at proximal margin:
Circumference at ulnar styloid:
Circumference at MCP 2-5:
Dorsal/Palmar thickness:
Measurements - Contralateral Side
Circumference at ulnar styloid:
Circumference at MCP 2-5:
Dorsal/Palmar thickness:
Length of ulnar styloid to 3rd MCP:
Additional Notes:
Due Date (please allow 7 business days for production time. Shipping time not included)

Month Day Year
Date Date Picker Icon
Please let us know when we can expect your files emailed or positives shipped:
Have a question?

No problem. Contact us and we'll walk you through the process.
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