No Needle or BP on Right Arm Italian Charm Fashion Bracelet Medical Alert Stretches over your hand. Any size. We will send a standard 7 inch bracelet unless you contact us with another size. We have other medical charms you can purchase and add in this bracelet if needed. Italian charms are always interchangeable if you decide to take out or add other Italian charms. You will also receive 3 extra links and instructions on how to add or take out charms and links.