Hoosier Model Mask #5616 for Broken Nose

Rx: 12/31/15 face mask for basketball / Jim W./Crystal Lake, IL

Diagnosis: broken nose / ICD-9 802.0

Plan: Fabricate Hoosier model Hoosier basketball face mask. Use clear DuPont Surlyn with black straps. Broken nose only.

Sx: Order received 12/31/15 @ 1:54 PM via website www.indianabrace.com. Shipped USPS Priority 01/04/16 Expect delivery in 2 days.

FU: email customer satisfaction questionnaire on 1/14/16

Clyde Peach, CO
www.indianbrace.com