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

VertAlign® Measurement Chart

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.

VertAlign® Measurement Chart

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.

VertAlign® Order Form

Accessories Order Form

VertAlign® Custom Order Form

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.

New Account 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.