Need help?+334 78 37 07 37
JLF Pro

Customprescription

1 2 3 4
1
Your request concerns:

For which industry is this request made?

Your request for a customized prescription is about

2
Chaussures / semelles
Activities undertaken:

Working environment:

Footwear worn:

Gants
For which type of hazards do you need to be protected from ?

What is the type of work conditions ?

For how many working days do you keep your gloves ?

3
Chaussures / semelles
Desired effects (Categories from 1 to 10: where 10 is the most important factor)
Particular issues:

Gants
Desired effect

Specific Problems

Comments:
4
Your informations