Your Liner - Prescription & Order Form - MULTILINGUAL

Welcome to the Your™ Liner ordering platform
Your™ Liner can only be ordered by a Certified prosthetic technician. If you are a user and are curious about how Your™ Liner could help you in your daily life, please get in touch with your CPO.

This ordering platform has been developped to guide CPOs towards providing us with all the info we need to make the best liner possible.

Your™ Liner is a custom-made medical device. All the details you can provide to let us understand what you expect can make the difference to help us make that great liner you're waiting for !

Simply follow the steps, and don't hesitate to give more info than less.

Happy ordering !

General guidelines on how to use the present platform

3D Modeling Instructions

Provide us with the info we need to make the best 3D model possible for Your™ Liner
MEASUREMENTS

Height from distal [cm]

Perimeter - tight [cm]

Perimeter - loose [cm]

Height 1

Height 2

Height 3

Height 4

Height 5

Height 6

Height 7

Height 8

Height 9

Height 10

SHORE HARDNESS
Choose a shore hardness, a default thickness profile is selected. You can customise the thicknesses by adding padding areas & compensations in the next section. *

Relax (Shore A0) Active (Shore A5) Dynamic (Shore A10)
/! WARNING /!

Relax silicone should be used only for patients with VERY limited activity levels. For a {activityLevel} patient like {patientName}, the durability will be limited.

By still choosing Relax silicone for a {activityLevel} patient, you can not place warranty requests in case of failure / breakage of the silicone body of Your™ Liner.

We kindly but strongly advise to choose Active silicone instead.
I have taken due notice to the warning above and still want to proceed with Relax silicone.
/! WARNING /!

Dynamic silicone might make the donning and doffing harder. For patients with limited prehension / strength, it may not be the most suited option.

You indicated that {patientName} has a {activityLevel} activity level. Are you sure this is the right choice for him ?

Help: Shore hardness selection guidelines

OPTIONAL: THICKNESS CUSTOMISATION

The stump presents sensitive spots / needs compensations ? Optionally, draw zones on the stump to add cushioning pads on top of the Your™ Liner Default thickness profile

Help: How to choose the right paddings

Draw zones on the stump and use the table below to add cushioning pads / compensations / provide indications on what thicknesses you want

Tissue type

Thickness [mm]

Why / comments

Zone 1

Zone 2

Zone 3

Zone 4

Zone 5

Zone 6

Zone 7

Zone 8

Zone 9

Other 3D modeling instructions
Liner length should be at least *
cm
Desired knee pre-flexion
Max 15° for pin-lock / max 35° for cushion & suction. Scan stump with desired flexion angle
I want to validate 3D model before printing

Yes (+3 days lead-time) No

Uploads

Upload pictures and scans & finalise your order
OTHER COMMENTS
Write any additional comments you may have
e.g. instructions for 3D design ; specific request / points of attention, etc.
UPLOADS
What did you scan?

I scanned my patient's limb directly I scanned a positive model (plaster cast)
Reduction you applied on the positive model
[%] - What reductions did you apply ? Where ?
Upload your scan(s) here *

.stl, .obj, .ply, .cpx or .zip format - preferably upload 2 scans
Cancel of
Upload pictures of the stump here *

At least 4 pictures (Anterior, Posterior, Medial, Lateral). More pictures are welcome !
Cancel of
Signature *

I agree to MotionTech's Terms & Conditions for the Your™ Liner service. Clear
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