Forms

The Bremer Group customer service team is committed to helping our clients with product and reimbursement assistance. The following forms are provided for convenience and represent the most commonly requested items. If you have any further questions or need other help regarding the VertAlign® Spinal Support System, please call customer service at 800.428.2304.

Please Note: Editing the forms on this page requires
Acrobat Reader 11.2 or higher

vert measure thumb VertAlign® Measurement Chart
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vertreg order thumbVertAlign® Order Form
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This chart provides measurements (in inches) for the VertAlign® System components including: male standard, female standard and female plus components. Remember, you may mix and match front and back shells for the best balance of fit and function.

 

 

 

accessories order thumbAccessories Order Form
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custom order thumb VertAlign® Custom Order Form
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new account thumbNew Account Form
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The Bremer Group Company recommends that practitioners consider ordering a Custom VertAlign® back brace for patients with non-standard anatomy or with significant degrees of thoracic deformity. Simply complete this form and fax it to The Bremer Group customer service at 904.645.0990 or ship it with your cast or mold to the address provided on the form.

Become eligible to offer the VertAlign® System. Simply complete this form and return it to your Bremer Group sales representative or via fax to The Bremer Group customer service at 904.645.0990.

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