866-236-8889
877-406-4872
To Order a Stat-A-Dyne ROM product or Vector 1 Hand CPM, Lantz Medical will need the following patient information:
1. Patient demographic information (Address, DOB, Phone #, Insurance Information)
2. Prescription (LMN) from the ordering physician.
*Medicare patients require a Detailed Written Order from their physician. A Detailed Written Order for all of our products can be found below.
3. Recent Physician and Therapy notes.
4. Custom Measurement form. Our Custom Measurement form can be found below.
Please fax all information to (877)406-4872, you may also email your order to info_lantzmedical.com
Feel free to call us at (866)236-8889 if you have any questions or concerns.
Measurement Form
Vector 1 LMN
Stat-A-Dyne LMNs
Medicare Forms
UE Meas Form Working.pdf
Stat a Dyne LMN.pdf
Detailed Written Order and Explainer (All StatADyne) 10 24 2011.pdf
LMN Vector 1.pdf
Stat a Dyne ProSup LMN.pdf
Stat a Dyne Elbow LMN.pdf
Copyright © 2011 Lantz Medical, All rights reserved.
