Individual Adaptive Clothing Request

We do our best to fulfill your order as listed from available stock on hand. Substituitions may be sent.
Name (First and Last)(required):Enlistment Date (required):
Shipping Address (required):
Shipping Address 2:
Shipping Address 3:
City (required):State (required):Zipcode (required):
Phone (required):Email (required):

Shorts / Pants See pictures of our clothing

Show Pants adapted in which way?   Left   Right   Double   Wheel Chair  
Please Limit quantity to 1 set of undergarments (4 pairs come in a set) and 2 or less items in the other rows.
Elastic waist & snap closureSmallMediumLargeXlargeXXLarge
Fits Waist Sizes:28"- 31.5"32"- 35.5"36"- 39.5"40"- 43.5"44"- 47.5"
 Adaptation
BoxersLeft
BoxersRight
BoxersDouble
Athletic ShortsOnly offered
in Double
Lounge PantLeft
Lounge PantRight
Lounge PantDouble
Swim TrunksLeft
Swim TrunksRight
Swim TrunksDouble

Fixator Pants

We stock pants for 36 inch diameter fixators. Other sizes will be custom made.
QuantityWaistLengthFixator Diameter
(We stock 36)

Wheelchair Lounge Pants

These are special order. Please list your waist and inseam measurements and allow 3 wks for delivery.
QuantityWaist:Inseam:

Shirts See pictures of our clothing

Show Shirts adapted on which side?   Left   Right   Double  
Please Limit quantity to 2 or less per row.
 SmallMediumLargeXlargeXXLarge
Fits Chest Sizes:34"- 37.5"38"- 41.5"42"- 45.5"46"- 49.5"50"- 53.5"
 Adaptation
T-shirt - TorsoLeft
T-shirt - TorsoRight
T-shirt - TorsoDouble
Long Sleeve Shirt- TorsoLeft
Long Sleeve Shirt- TorsoRight
Long Sleeve Shirt- TorsoDouble
Polo Shirt - TorsoLeft
Polo Shirt - TorsoRight
Polo Shirt - TorsoDouble
Button Front Shirt(velcro under buttons)
Limited to on-hand stock and colors
Quantity Neck Size:
Comments or Special Requests