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Forms and Brochures

For complete Instructions for Use, warnings, precautions and contraindications, please access the KCI e-labeling site.

V.A.C. Therapy Order Forms

Acute Care Forms

V.A.C.® Therapy ordering forms and sample documents specifically for the Acute Care and Long Term Acute Care (LTAC) settings.

PDF V.A.C.® Therapy Insurance Authorization Form 13-0209.US, V.5
PDF V.A.C.® Therapy Acute Order Prescription Pad 13-0396.AC

Post Acute Care Order Forms

V.A.C. Therapy ordering forms and sample documents specifically for the Post Acute Care settings, including Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Wound Care Clinics (WCCs).

PDF V.A.C.® Therapy Insurance Authorization Form 13-0209.US, V.5
PDF   V.A.C.® Therapy Post Acute Prescription Pad 13-0395.PA
PDF V.A.C.® Therapy Monthly Wound Progress Form 29-K-011 Rev. 8/08
PDF V.A.C.® Therapy Discharge Form 29-K-101 Rev. 8/08
PDF Letter of Medical Necessity for Excessive Supplies 29-K-109 Rev.8-08

V.A.C. Therapy Usage Support Materials

KCI offers extensive support materials for V.A.C. Therapy, including product brochures, training materials, guidelines for use and online videos. For more information, download a specific PDF document or click to watch the video presentation.

V.A.C. Therapy Application Guides

PDF Basic V.A.C.® Therapy Dressing Application Pocket Guide 11-0713.US Rev. 12/11
WMV V.A.C.® Dressing Application Overview
WMV V.A.C.® GranuFoam Silver® Dressing Application Overview
WMV V.A.C.® Simplace™ Dressing Application

InfoV.A.C.® Therapy Literature

PDF InfoV.A.C.® Troubleshooting Card 12-0711.US

ActiV.A.C.® Therapy Literature

PDF ActiV.A.C.® Therapy System Brochure 14-0557.US
PDF ActiV.A.C.® Specification Sheet 14-0012.US

Other V.A.C. Therapy Unit Literature

PDF V.A.C. Therapy 101 Brochure 14-0389.US
PDF V.A.C. Freedom® Troubleshooting Card 13-0550.US


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