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Location
• • •
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Measurements
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Height_____in
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Weight_____lbs
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Band Size
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Cup Size
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Current Form Shape
• • •
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Others, please specify
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Skin Condition Observed
• • •
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Comments
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Product(s) Given
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Manufacturer
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Style No
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Form Shape
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Size
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Manufacturer
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Style No
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Bra Size
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Color
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Qty
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Cost
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Manufacturer
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Style No
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Bra Size
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Color
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Qty
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Cost
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Manufacturer
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Style No
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Bra Size
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Color
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Qty
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Cost
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Signature
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CARE PLAN
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Please select from the following
• • •
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Others, please specify
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Problem Noted
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Follow up appointment for_______(date)
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No problems noted or complaints offered by client. Advise to call if she has questions or concerns regarding fit and comfort. I
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Fitter
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Date
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