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Order Forms and Tape Kits

Request Forms and Tape Kits be Sent to You

Our tape kits and forms are just a few mouse-clicks awayPlease indicate the quantity of each tape kit or form desired in the "Qty" column, then complete the mailing and contact information. Requests from qualified professionals only will be honored. PDF versions of the forms alone may also be downloaded. Obsolete versions of these forms are still available. Fax this request to: (866) 474-8822, or mail to: Gottfried Medical, Inc., PO Box 8966, Toledo OH USA 43623.

Other Manufacturer's Forms

Our measuring system and forms are interchangeable with those used by other major manufacturer's and the IMF system. We gladly accept orders submitted on forms other than our own. Authorization to substitute is not required.

All orders require a prescription, regardless of the form used.

Gottfried Medical Tape Kits and Current Forms

Item Qty Description View Item
Tape Kit Upper Extremity One each of: Form No 10 Prescription Blank, Order Form 21, AT-1 Paper Tape, Pre-addressed Return Envelope  
Tape Kit Chest, Waist, Knee & Stump One each of: Form No 10 Prescription Blank, Order Form 11, Pre-addressed Return Envelope and 2 each of: LT-2 Paper Tape
Tape Kit Knee One each of: Form No 10 Prescription Blank, Order Form 11, Pre-addressed Return Envelope and 2 each of: KT-1 Paper Tape
Tape Kit Glove & Gauntlet One each of: Form No 10 Prescription Blank, Pre-addressed Return Envelope and 2 each of: Order Form 31 and FT-1 Paper Tape
Form
No 10		 (R11W3) Prescription Blank  
Form
No 11		 (A-13-AY3) Order chest, waist, thigh, and knee length and supports. Instructions on how to measure with paper tapes
Form
No 12 		(A-11-W) Order anklet, thigh, knee length, and AK or BK stump supports. Instructions on how to measure without paper tapes.
Form
No 14		 (A-13-SY) Order stump supports.
Form
No. 21		 (A-12A-W3) Order arm sleeves and gauntlets with paper tapes
Form
No. 22		 (A-12-W) Order arm sleeves and gauntlets, without paper tapes
Form
No 31		 (B-1-W) Order gloves and gauntlets with paper tapes
Form
No 32		 (B-1A-W)Scaled tracing of hand for optimal fit
Form
No 33		 (B-2-W) Order face masks and chin straps with paper tapes
Form
No 34		 (B-3-W) Order body suits, briefs and boleros with paper tapes
Form
PNB		 Order garter belts Made-to-Measure and sized
Contact and Delivery Information
All Fields Must be Completed
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Please visit our Contact Page for all other inquiries.

Learn More about Gottfried Brand Products

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Call us for live assistance and courteous, toll-free supportFor Immediate Assistance

Call us, toll-free, (800) 537-1968, M - F, 8am - 6pm, Eastern Time. Visit our Website for more information on the form-based inquiry options available to you and answers to questions we are most frequently asked.

Call us, toll-free, (800) 537-1968, M - F, 8am - 6pm, Eastern Time. Optionally, select an inquiry form that best describes you, your business or institution. Follow this link for the answers to questions we are most frequently asked.

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Important Note to Consumers: Gottfried Medical, Inc., has provided this information in an effort to answer some of the common questions professionals ask about our company and its products and services. If you have any questions regarding this information, or are concerned about your health, we urge you to consult a physician.