Register Your TheraTogs Product

Product Registration

Please fill out the requested information below to the best of your abilities. We suggest you have the exterior packaging (typically a ziplock bag) *or* your order paperwork handy, as it has information you'll need to fill out the form. Customers who complete the Product Registration form will receive a free thank-you gift, as an expression of our appreciation for providing your information!

Privacy and Consent*
We will protect the privacy of any data you provide us. Your information will not be shared, and you’ll receive a confirmation email when you submit this form. You can review our full Privacy Policy here.
I agree to the privacy policy.
Your Relationship to TheraTogs Wearer*
- Wearer
- Parent / Caregiver
- PT
- OT
- CO / CPO
- Other
Caregiver Name*
First Last
Caregiver Email*
Caregiver Address*
This is the address to which we will send our Product Registration thank-you gift!

Street Address Address Line 2 City State ZIP Code
Therapist or Clinician's Name
First Last
Therapist or Clinician's Email
Name of Clinic or Practice
Product Information
These optional questions pertain to the TheraTogs product you received.
Registration Number*
Please enter the unique Product Registration Number (PRN) that will be found on the outer packaging of your TheraTogs system. If you don't have a PRN, enter today's date in DDMMYYYY format, numbers only.
Date You Received Your TheraTogs
Date Format: MM slash DD slash YYYY
TheraTogs Size & Model Code
Enter the size and model code found on your product package. Example: "GPTA210".
Age of Wearer
Enter in months, or months + years. Examples: "6 mo" or "2 yrs + 3 mo".
Primary Diagnosis or Indication*
Enter the primary diagnosis or indication(s) which this TheraTogs system is intended to address.
Quick Survey
Answers here are optional, but much appreciated!
Is this your first TheraTogs system?
- Yes
- No
Where/how did you first hear about TheraTogs?
- From therapist or clinician
- From parent or caregiver
- By searching the Web
- From website or blog
- From email or newsletter
- At tradeshow, conference, or other meeting
How were your TheraTogs purchased?
- Out of pocket / cash pay
- Insurance reimbursement
- Medicaid / Medicare
- Early Intervention program
What Billing Code was used
(If you know, that would be very helpful... this is usually a code like L0456, L1499, or something similar.)
If reimbursed, by which payor (Medicaid, government program, or insurance company?
Who were your TheraTogs obtained from?
- Clinician / Clinic / Health care facility
- O&P Provider
- DME Supplier
- Catalog or Distributor
TheraTogs Seller
Please enter the name of the organization from whom your TheraTogs were purchased, if known.
Name
This field is for validation purposes and should be left unchanged.

Save and Continue Later

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Therapy You Can Wear!

TheraTogs are orthotic undergarment and strapping products that give individuals with sensorimotor impairment a highly effective modality for improving postural alignment, stability, movement skill, precision, joint stability, and prolonged muscle stretch. TheraTogs are an FDA-registered Class I medical device.

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Email*
Consent*
I agree to be contacted by TheraTogs, Inc.
Comments
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Upcoming Events

Jun

4

Thu

4:00 pm TheraTogs AMA – Live Q&A with Be... @ Live Webinar via Instagram

TheraTogs AMA – Live Q&A with Be... @ Live Webinar via Instagram

Jun 4 @ 4:00 pm – 5:00 pm

TheraTogs inventor and co-founder Beverly (Billi) Cusick will be stepping up to the webcam June 4th for another live “Ask Me Anything” session on TheraTogs. The session is sponsored and hosted by FisioVital, the exclusive[...]

Nov

13

Fri

all-day Academy of Pediatric Physical Th... @ Omaha Convention Center

Academy of Pediatric Physical Th... @ Omaha Convention Center

Nov 13 – Nov 15 all-day

We will be exhibiting at the annual Pediatrics conference, as usual. Stay tuned for updates – there’s big news coming!

View Calendar