PATIENT USAGE FORM

It is the responsibility of the health care professional completing this form to submit the information to the distributing facility. If any questions, problems, or adverse reactions occur, please notify Alamo Biologics at 210.738.2663 or 800.226.9091 and we will be happy to assist you.

Tissue is for single use only. Up to four allografts can be included on this form. One patient, one procedure per tracking form. Please complete the information below.