Marilyn Westbrook Garment Program

 
 

The first soft Relaunch of the program accepted Applications Monday 10/29/18 - 11:59pm PT Tuesday 10/30/18. Applications submitted from 10/31/18 until the second soft relaunch on Monday, 12/3/18 were not accepted.

The second soft relaunch was, Monday, December 3, 2018.

The objective of the soft relaunches is to make sure the process and workflow that has been set is effective and efficient.

The next time applications will be accepted is January 14, 2019.

 

Program Guidelines

  • All applications must be submitted electronically via our website application form below.

    • Any paper submissions using the former paper application that are mailed or faxed will not be accepted or acknowledged.

    • Any direct email messages not submitted through our form below, containing the same information on the application form below, will not be accepted.

  • Only applications submitted by active Affiliate Members of the National Lymphedema Network will be accepted.

    • This program is not available to non-Affiliate Membership or the general public.

  • Patients must have completed a course of Complete Decongestive Therapy and be at the point of maximal volume reduction and be independent with a home program.

  • One set of daytime compression garments or night-time compression garments will be provided, not both.

  • Any initial application submitted with identified PHI will not be accepted. When the final approval email is sent the PHI will be stripped away and replies with measurements should include the patient’s actual name.

  • The turnaround time to receive a notice of acceptance on the initial application is 14 days from the time of submission. The second level of the application process includes submission of a photo, prescription, and letter of medical necessity. The final step in the application process will request the patient’s information including custom measurements and shipping address. Communications will close with an email to the affiliate therapist

  • Applications for custom garments must include rationale and explain why ready-to-wear compression garments are not being requested.

    • Accepted applications will have measurements for custom garments submitted within this time frame.

    • If there are any recommended changes or questions from the Garment Program committee, therapists have 7 days to respond.

      • Delayed responses, greater than 14 days, will void the application and a new one will need to be submitted.

  • The Garment Fund committee has the ability to accept applications contingent upon acceptance of a different garment recommendation.

  • Financial information will no longer be required. Confirmation of financial need in the Applicant’s Personal Statement will suffice.

  • There will be absolutely no remakes of any custom garment accepted through the Garment Fund. Any therapist who attempts to circumvent the Garment Program process to obtain remakes, and not abide by program guidelines, may be removed from future participation in the Garment Program.

  • At the discretion of the Garment Fund committee, individual therapists may be removed from participation in the Garment Program due to lack of professionalism including disrespectful communication with the Garment Program committee or any of the participating sponsoring manufacturers.

  • Requests for accessories, such as garment liners, that do not come standard with the chosen compression garment will not be accepted.

APPLICATION Form

 
Affiliate Therapist Info
Affiliate Therapist Name *
Affiliate Therapist Name
Phone Number *
Phone Number
Patient Info
Does the patient have congestive heart failure? *
Does the patient have arterial insufficiency? *
Has patient completed CDT and achieved max volume reduction? *
Body Regions Affected *
Has the patient demonstrated apparent compliance with home program? *
Custom Compression Garments
By submitting this application on behalf of my patient, I agree there will be no remakes for any errors of measurement or inaccuracies in completion of the measurement forms. *
For therapists who are new to measuring for the brand of compression garment, I acknowledge that I have worked directly with a local representative of the manufacturer or that I have received educational guidance directly from the manufacturer. *
I acknowledge that the patient and/or I will assume full responsibility for the cost of any needed modifications or remakes of garments. *
Has the patient attempted to fit into ready-to-wear compression garments? *
Ready-to-wear Garments