Stocking Measurement Guide

Please use the form below to submit your measurements for medical stockings. 

Measurements for the Left leg can be found on the first page of the form. Please proceed to the second page for measurements for the Right leg. 

 

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Personal Details
We require your personal details so we can match your submission to your medical records. Please complete all Mandatory fields.

Use this image as a reference for where the measurements should be taken.

Left Leg Measurements
Please input the measurements for your LEFT leg in the fields below. Measurements should be taken in cm
Use the image above as a reference for where the measurements should be taken.
 
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Use this image as a reference for where the measurements should be taken.

Right Leg Measurements
Please input measurements for your RIGHT leg in the fields below. Measurements should be taken in cm
Use the image above as a reference for where the measurements should be taken.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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