STEP 8 Add Logo (Additional charges apply) ■ No LogoLogo is left chest placement only. See page 2 for placement diagram. ■ Customer Logo – Please send JPEG artwork with this form to orders@coneinstruments.com■ Vendor Stock Design – View options at www.shieldingintl.com/embroidery■ Medtronic Logo (Model #CCN17515)

STEP 3 Choose Protection Option TL, TLL = Lite Ply 15–20% Less Weight ($ Additional charges apply.)

■ TL (0.5mm LE) ■ TLL (0.35mm LE)

STEP 4 Choose Apron Fabric and Color Please Enter 2-3-Digit Code from page 3

STEP 5 Choose Belt Size – Back Relief (WABR only) Size: ■Small, 28"-38" ■Medium, 36"-48" ■ Large, 44"-58"

STEP 7 Choose Apron Embroidery – Model # 5086107 ($ Additional charges apply). Embroidery is left chest placement only. Block Style. Up to 20 characters per line, 2 lines Maximum. Please note: Embroidery is case sensitive and will be created exactly as written on lines below.

Choose Embroidery Color – ■Black ■White

STEP 1 Choose Model (ex: Vest Skirt Combo =VS)

STEP 2 Measure and place sizes into chart

CA

LL

: 80

0.32

1.69

64 /

FAX

: 80

0.98

7.C

ON

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Mconeinstruments

Your First Call for Medical Imaging Supplies

Wrap AroundWABR

VestVS, AFVS

SkirtVS, AFVS

Chest N/A

Waist

Hips N/A

LengthRecommended

length: top of knee

From sternal notch to desired length

From sternal notch to 2" below waist

Waist to desired length

Attention: Aprons are made to order and are non-returnable/non-refundable. Please be sure measurements are accurate.

1

Wrap-Around, Vest/Skirt Combo, or Adjust-A-Fit Aprons

Sizing Your Wrap-Around, Vest/Skirt Combo, or Adjust-A-Fit Aprons Chest: Distance around chest at underarm Waist: Distance around stomach at widest pointHips: Distance around hips at widest point (Size Charts available online)

Length

Length

Chest

Waist

Hips

VS AFVSWABR

See page 2 for placement diagram

Apron Options & Sizing Order Form Contact Name: Date:

Email: Phone: Ship to Address:

STEP 6 Patch Pocket (Model #45576) – ■Yes ■ No (Left chest placement only) ($ Additional charges apply).

STEP 9 Add Optional Thyroid Collar and Tether ($ Additional charges apply.) Collar Options Add Tether* Choose Thyroid Collar Fabric and Color

■ Small Comfort Fit Thyroid Collar #5086193 ■Please Enter 2-3-Digit Code from page 3 ■ Large Comfort Fit Thyroid Collar #5086194 ■

*Collar tethered to apron on right side by a ring for easy removal

Available ModelsAll Models have Patch Pocket only Skirts have additional Slit Pocket

WABR ......Wrap Around Back Relief with VelcroVS ...........Vest Skirt Combo with VelcroAFVS ......Adjust-A-Fit Skirt with Velcro

CA

LL

: 80

0.32

1.69

64 /

FAX

: 80

0.98

7.C

ON

E

C

LIC

K:

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INS

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Your First Call for Medical Imaging Supplies

2

Apron Options & Sizing Order Form Contact Name: Date: Email: Phone: Ship to Address:

STEP 10 Please indicate “L” for Logo, and/or “E” for Embroidery Placement Below:

STEP 11 Please indicate “L” for Logo, and/or “E” for Embroidery Placement Below:

Apron Personalization (optional) ($ Additional charges apply.)

Thyroid Collar Personalization (optional) ($ Additional charges apply.)

Left ChestOnly

Logo Placement = LEmbroidery Placement = E

Logo Placement = LEmbroidery Placement = E

Front Bib

Left StrapRight Strap

Choose Thyroid Collar Embroidery* – ■Black ■White

________________________________________________

________________________________________________*16 characters maximum on Right and Left Sides OnlyFor small Comfort Fit Thyroid collar (#5086103) cannot be embroidered on the left strap. Right and front side only.

CA

LL

: 80

0.32

1.69

64 /

FAX

: 80

0.98

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3

Nylon

Designer Fabric

Diamond Ripstop

BermudaBM

ButterfliesBUT

Pink CamoPC

Faux LeopardFAL

Orange FloralOF

Green SurfGF

Royal PawsRY

ZebraZB

Red FlamesRF

Chocolate FloralCFL

Hearts of ColorHC

Storm CamoSTC

Wild Cat PinkWC

Flower PowerFP

Tiki BlueTB

Dog PawsDW

Blue SquaresBSQ

Red PlaidRI

Royal PlaidROP

Gray SquaresGS

StarsTS

Green PlaidGL

SplatterSR

DenimDM

Blue PlaidBPL

White Lil’ CherriesWLC

Hot Pink PlaidHO

Desert CamoDO

AquaAQ

MaroonMN

Orange18

Light OrangeLIO

Forest GreenFO

NavyNV

PinkPK

CharcoalCC

TealTL

PurplePL

RedRD

Light BlueLB

Lime GreenLM

True RoyalTU

Hot PinkHP

SilverSI

YellowYL

TanTN

Royal BlueRL

MauveMV

CoffeeCOF

BlackBK

Black Diamond

BA

Kelly Green Diamond

KG

Red Diamond

RM

Fuschia Diamond

FD

Marine Blue Diamond

MBD

Silver Diamond

SVD

Cinnamon Diamond

CD

Lavender Diamond

LD

Royal Blue Diamond

RO

Charcoal Diamond

GM

Purple Diamond

PD

Slate Blue Diamond

SBD

Tan Diamond

TAD

Brown Diamond

BRD

FABRICS & COLORSconeinstruments

Your First Call for Medical Imaging Supplies