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Our Sockets
Above Knee
Below Knee
Above Elbow
Below Elbow
Hip Disarticulation
Shoulder Disarticulation
HealthySkin AM/PM
Socket-Soft Fitting Software
About Us
Our Mission
Video Gallery
Our Clinics
About Our Clinics
Clinical Outcomes
Clinical Network
Patient Forms
OKC Patient Forms
Austin Patient Forms
Tampa Patient Forms
Dallas Patient Forms
Ft. Myers Patient Forms
Contact Us
Join Our Team
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Socket-less Socket™ Order Form
The Socket-less Socket™ is Available for All Amputation Levels and All Limb Lengths
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Billing address same as shipping address
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State / Province / Region
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
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Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Socket Order Information (PO Number)
*
Socket ID# (If already provided by Martin Bionics)
Below Knee Products
Select
BK-Hybrid Socket-less Socket (right)
BK-Hybrid Socket-less Socket (left)
ICON BK Socket-less Socket (right)
ICON BK Socket-less Socket (left)
Soft-Socket BK Socket-less Socket (right)
Soft-Socket BK Socket-less Socket (left)
Below Knee Socket Quantity
*
Patient Weight
*
Mid-Patellar Tendon to End of Limb
*
Above Knee Products
Select
AK-Hybrid Socket-less Socket (right)
AK-Hybrid Socket-less Socket (left)
cX-Socket-less Socket AK (right)
cX-Socket-less Socket AK (left)
Soft-Socket AK Socket-less Socket (right)
Soft-Socket AK Socket-less Socket (left)
Swing Brim (right)
Swing Brim (left)
Lateral Stabilizer
Above Knee Socket Quantity
*
Patient Weight
*
Upper Extremity Products
Select
ICON Above Elbow Socket (right)
ICON Above Elbow Socket (left)
ICON Below Elbow Socket (right)
ICON Below Elbow Socket (left)
Fabric Shoulder Socket Fabrication
Magnetic Buckle Set
Upper Extremity Socket Quantity
*
Hip Disarticulation
Select
Bikini Socket Iliac Crest Stabilizer
Bikini Socket Hammock Casting Stand
Fabric to Socket Buckle
Hip Disarticulation Quantity
*
Other Products
Select
Sharkskin Suspension
NASA-based 2D Mesh, (1 yard)
Other Quantity
*
Fabrication
Select
Test Socket Fabrication
Flexible Inner Liner Fabrication
Final Fabrication - Above Knee
Final Fabrication - Below Knee
Final Fabrication - Above Elbow
Final Fabrication - Below Elbow
Final Fabrication - Hip Disarticulation
Final Fabrication - Shoulder Disarticulation
Fabrication Quantity
*
Products & Services
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Healthy Skin AM/PM (single)
In-Person Clinical Services
Products & Services Quantity
*
Hidden
Amputation Side
*
Left
Bilateral
Right
Hidden
Socket Configuration
BK-Hybrid™
ICON BK™
Soft-Socket™
Hidden
Socket Configuration
cX-Hybrid™
SwingBrim™
Soft-Socket™
Hidden
Socket Configuration
ICON AE™
Hidden
Socket Configuration
ICON BE™
Hidden
Socket Configuration
Bikini Socket™, Iliac Crest Stabilizers™️
Hammock Casting Stand™
Hidden
Socket Configuration
Fabric Shoulder Socket™
Preferred Socket Suspension
Pin Lock
Suction/Vacuum
Other
Are you mailing us a check socket?
*
Yes
No
Ship check sockets to Martin Bionics Orders, Attn: Fabrication, 214 East Main Street, Oklahoma City, OK 73104
Special Instructions
Components Being Sent with Socket
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You're Just Steps Away From More Comfort!
Medicare, VA and insurance approved. Available for all amputation levels.
How old is your current socket?
< 6 months
6 mo - 2 yrs
> 2 years
I am a new amputee or don't have a socket
Select all issues you are having with your current socket
Pain or Discomfort
Restricted Range of Motion
Skin Breakdown or Blisters
Worn or Broken
Difficulty Managing Fit
Uncomfortable While Sitting
Weight Loss or Gain
Pistoning or Lack of Suspension
Instability
Excess Heat and Sweat
None / No socket
What interests you about our socket technology?
I want a cooler and more breathable socket.
I want more comfort and conformity.
I want unrestricted range of motion.
I want a self-adjustable socket.
I want to regain quality of life.
Let our Socket-less Socket™ Experts Help you Discover Comfort.
Fill out your info to receive a follow-up from one of our Socket-less Socket™ experts.
Who do we have the pleasure of talking with?
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FIRST NAME
LAST NAME
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Which best describes you?
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Select One
Below Knee
Knee Disarticulation
Above Knee
Hip Disarticulation
Shoulder Disarticulation or Forequarter Amputee
Hemipelvectomy
I am a prosthetist
I am a family member of an amputee
Below Elbow
Elbow Disarticulation
Above Elbow
Shoulder Disarticulation
Forequarter
Other
Amputation Side
Left
Bilateral
Right
What questions can we answer for you?
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Would you like us to check your prosthetic coverage now?
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Yes, check my insurance now
No thanks, I just have questions
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