Elite Brite Product Order Form

Knee Braces

Knee Immobilizer [Tripanel Knee Immobilizer]

Product No. LY-K12-KI

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Lightweight Universal ROM Knee Brace

Product No. AW-K09-PostOPROM

$ Free QuantitySize Universal

  

Unloader Adjustable [Lightweight Unloader Knee Brace-Grey]

Product No. KL-K07-UKB-GY 

$ Free

Side	Quantity	Size
Left		Universal
Right		Universal

  

Adjustable Neoprene Knee Brace

Product No. AW-K05-NSHKB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Compact Knee Brace

Product No. E-K014-KN043

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Functional Knee Brace

Product No. E-K013-KN034

$ Free

Size	Quantity
S - Left Side
S - Right Side
M - Left Side
M - Right Side
L - Left Side
L - Right Side
XL - Left Side
XL - Right Side

  

Air and Ice Knee Brace

Product No. AW-K04-AIKB

$ Free QuantitySide Universal Size Universal

  

ACL Knee Brace

Product No. AW-K08 FKB

$ Free

Size	Quantity
S - Left Side
S - Right Side
M - Left Side
M - Right Side
L - Left Side
L - Right Side
XL - Left Side
XL - Right Side

  

Unilateral OA Brace [Unloader Knee Brace]

Product No. AW-K06-UKB

$ Free

Side	Quantity	Size
Left		Universal
Right		Universal

  

Adjustable Knee Orthosis [POSTOP ROM Knee Brace]

Product No. LY-K10-PostOPROM

$ Free QuantitySide Universal Size Universal

  

Eco Hinged Knee Wrap [Hinge Knee Wrap]

Product No. AW-K01-EHKB

$ Free

Size	Quantity	Side
XS		Universal
S		Universal
M		Universal
L		Universal
XL		Universal
XXL		Universal

  

Pro Hinged Knee Wrap

Product No. AW-K02-PHKB

$ Free

Size	Quantity	Side
XS		Universal
S		Universal
M		Universal
L		Universal
XL		Universal
XXL		Universal
XXXL		Universal

  

ROM Hinged SBR Knee Wrap

 Product No. AW-K03-ROMHKB

$ Free

Size	Quantity	Side
M		Universal
L		Universal
XL		Universal

  

Ankle Braces

TP Knee AirLiner Walker [Tall Walking Boot]

Product No. AW-A01-LAB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

TP ANKLE AIR LINER WALKER [Short Walking Boot]

Product No. AW-A02-SAB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Ankle Cast Boot

Product No. AW-A03-SCB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Knee Cast Boot

Product No. AW-A04-LCB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Short Air Cast Boot

Product No. AW-A05-SACB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Knee Air Cast Boot

Product No. AW-A06-LACB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Ankle Brace [Universal Ankle Brace]

Product No. LY-A11-WRP-U

$ Free QuantitySide Universal Size Universal

  

Ankle Splint GEL

Product No. LY-A10-AS

$ Free

Size	Quantity	Side
Small - Children		Universal
Large - Adults		Universal

  

Ankle Splint AIR

Product No.  LY-A10-AS

$ Free

Size	Quantity	Side
S - Children		Universal
L - Adults		Universal

  

Air/Gel Ankle Brace [Ankle Splint]

Product No. AW-A18-AGB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal

  

AirFoam Ankle Brace

Product No. AW-A19-AFB

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal

  

Easy-lace Up Ankle Brace

Product No. AW-A07-LCE

$ Free

Size	Quantity	Side
XS		Universal
S		Universal
M		Universal
L		Universal
XL		Universal
XXL		Universal

  

Night Splint [I]

Product No. LY-A08-NS

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal

  

Night Splint [II]

Product No. AW-A20-NS-BLK

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

AFO

Product No.  AW-A15-AFO

$ Free

Size	Quantity
S - Left
S - Right
L - Left
L - Right

  

AFO with Pad and Straps

Product No. AW-A16-AFOPD

$ Free

Size	Quantity
S - Left
S - Right
L - Left
L - Right

  

Anterior Night Splint- No Anterior Strap

Product No. XG-A13-ANS 

$ Free Quantity 1 2 3 4 5 6 7 8 9 10 Side Universal Size Universal

  

Anterior Night Splint with Anterior Strap

Product No. XG-A12-ANS-ST

$ Free QuantitySide Universal Size Universal

  

Wrist Braces

Short Wrist Brace

Product No. LY-W01-SH

$ Free

Size	Quantity
S - Left
S - Right
M - Left
M - Right
L - Left
L - Right
XL - Left
XL - Right

  

Universal Wrist Brace

Product No. LY-W02-U

$ Free QuantitySide Universal Size Child Universal Adult Universal

  

Adjustable Forarm Support [Wrist and Forearm Brace]

Product No. LY-W03-WFS

$ Free

Size	Quantity
S - Left
S - Right
M - Left
M - Right
L - Left
L - Right
XL - Left
XL - Right

  

Thumb Protection Brace

Product No. LY-W04-THB-U

$ Free QuantitySide Universal Size Universal

  

Thumb Brace [Wrist with Thumb Brace]

Product No. LY-W05-TSB

$ Free

Size	Quantity
S - Left
S - Right
M - Left
M - Right
L - Left
L - Right

  

Shoulder Braces

Arm Sling [Deluxe Arm Sling]

Product No. LY-S04-SL-UDLx

$ Free QuantitySide Universal Size Universal

  

Arm Sling [Standard Arm Sling]

Product No. LY-S05-SL-USTD

$ Free QuantitySide Universal Size Universal

  

Multi-function Arm Sling [Universal Immolizer Sponge Type]

Product No. LY-S06-SI-U

$ Free QuantitySide Universal Size Universal

  

Deluxe Shoulder Immolizer

Product No. AW-S07-DSI-U

$ Free QuantitySide Universal Size Universal

  

Shoulder Abduction Orthosis

Product No. LY-S02-ABSL

$ Free

Size	Quantity	Side
S		Universal
M		Universal
L		Universal
XL		Universal

  

Shoulder Abduction Orthosis [Shoulder Abduction Arm Sling, Universal]

Product No. LY-S01ABSL-U

$ Free QuantitySide Universal Size Universal

  

Deluxe Clavicle Support

Product No. AW-C01-DCS

$ Free

Size	Quantity
S
M
L
XL

  

Clavicle Brace

Product No. LY-C02-CB

$ Free QuantitySize Universal

  

Back Braces

Lumbar Support Orthosis (II) with Side Pads

Product No. : LY-B06-LSO-SP

$ Free QuantitySize Universal

  

Lumbar Support Orthosis (I) Universal LSO

Product No. LY-B01-LSO-U

$ Free QuantitySize Universal

  

Cervical Thoracic Orthosis

Product No. LY-B02-CTO

$ Free

Size	Quantity
M
L

  

ThoracoLumbar sacral Orthosis (I) Thoracolumbar Brace

Product No.  LY-B04-TLSO (I)

$ Free

Size	Quantity
XS
S
M
L
XL
XXL

  

Thoracolumbarsacral orthosis tlso (II)

Product No. : LY-B05-TLSO (II)

$ Free

Size	Quantity
XS
S
M
L
XL
XXL

  

Back Support Lumbar Support/Back Belt

Product No. : LY-B06- LBS

$ Free

Size	Quantity
S
M
L
XL

  

Lumbar support/Back belt

Product No. : XG-B09-LBS(II)

$ Free

Size	Quantity
S
M
L
XL
XXL

  

Lumbar Support Brace LSO (III) BLK padded

Product No. :  KL-B03-LSO-U

$ Free

Size	Quantity
Universal

  

Thoracolumbar Sacral Orthosis(III)

Product No. : LY-B07-TLSO(III)

$ Free

Size	Quantity
S
M
L
XL

  

Thoracolumbar Sacral Orthosis (IV)

Product No. :LY-B08-TLSO-U

$ Free

Size	Quantity
Universal

  

Neck Braces

Cervical Collar [Rigid Adjustable Collar]

Product No. LY-CV01-AWC

$ Free

Size	Quantity
S
M
L
XL

  

Soft Collar-Beige

Product No. LY-CV02-SC-BGE

$ Free

Size	Quantity
Children - S
Children - M
Children - L
Adults - S
Adults - M
Adults - L
Adults - XL

  

Soft Collar-Blue

Product No. LY-CV03-SC-BLU

$ Free

Size	Quantity
Children - S
Children - M
Children - L
Adults - S
Adults - M
Adults - L
Adults - XL

  

Philadelphia Cervical Collar

Product No. LY-CV04-PC

$ Free

Size	Quantity
S
M
L
XL

  

Emergency Cervical Collar

Product No. LY-CV05-EC

$ Free QuantitySize Universal

  

Adjustable Cervical Collar

Product No. LY-CV06-ACC

$ Free QuantitySize Universal

  

Finger Splints

Curved Finger Splint

Product No. AW-FR07-CFS

$ Free

Size	Quantity
S
M
L
XL

  

Quarter-Foil Finger Protection

Product No. AW-FR01-QF

$ Free

Size	Quantity
S
M
L

  

Baseball Splint

Product No. AW-FR03-BS

$ Free

Size	Quantity
S
M
L

  

Finger Cot

Product No. AW-FR02-FC

$ Free

Size	Quantity
XS
S
M
L

  

Extension Finger Splint

Product No. AW-FR04-EFS

$ Free

Size	Quantity
S
M
L

  

Frog Finger Splint

Product No. AW-FR05-FFS

$ Free

Size	Quantity
S
M
L

  

Stack Splint

Product No.  AW-FR06-SS

$ Free

Size	Quantity
1
2
3
4
5
5.5
6
7
8

  

Foot Braces

Square Toe Postop Healing Shoe

Product No. AW-F02-SPO

$ Free

Size	Quantity	Side
XS		Universal
S		Universal
M		Universal
L		Universal
XL		Universal

  

Surgical Post-Op Shoe

Product No. AW-F01-PO

$ Free

Size	Quantity	Side
Pediatric		Universal
S		Universal
M		Universal
L		Universal
XL		Universal

  

Square Toe Ortho Wedge Healing Shoe

Product No. AW-F03-POW

$ Free

Size	Quantity	Side
XS		Universal
S		Universal
M		Universal
L		Universal
XL		Universal