Sample Pack Form – Lick Sleeve

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First Name *

Last Name *

Email *

Hospital Name *

Street Address *

City *

State/Province/Region *

Postal Code *

Country *

Requested Sample Sizes (pick 2) *

Leg Sleeve (XXS) 7-13 lbs / 3-6 kg
Leg Sleeve (XS) 13-20 lbs / 6-9 kg
Leg Sleeve (S) 20-30 lbs / 9-14 kg
Leg Sleeve (M) 30-50 lbs / 14-23 kg
Leg Sleeve (L) 50-80 lbs / 23-36 kg
Leg Sleeve (XL) 80-120 lbs / 36-54 kg
Leg Sleeve (XXL) 120-150 lbs / 54-68 kg

Recovery Suit (XXS)
Recovery Suit (XS)
Recovery Suit (S)
Recovery Suit (M)
Recovery Suit (L)
Recovery Suit (XL)
Recovery Suit (XXL)

Rear Bilateral (XXS)
Rear Bilateral (XS)
Rear Bilateral (S)
Rear Bilateral (M)
Rear Bilateral (L)
Rear Bilateral (XL)
Rear Bilateral (XXL)

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