Lower Extremity Amputation Prevention (LEAP) Test Kit Order Form

Place an order for a free Lower Extremity Amputation Prevention (LEAP) Test Kit and print publications.  Test kit contains a 5.07 monofilament, which delivers 10 grams of force to identify patients with a foot at risk of developing problems.

Contact Information
Organization Information
Use your Health Organization's Address and Email. Please do not enter any personal information.
Order Information

Order by the single filament or by packs of ten.

If ordering less than 10, please enter the number of single filaments you would like.
If ordering 10 or more, please enter the number of 10 pack filaments you would like.